browser life

After subjecting my fuzzy brain to the rigeurs of the Medicare website and utilizing search engines and message boards for a few days, I finally reached a point of clarity as to how the rules for coverage actually applied to me. The system certainly isn't conducive to being easily understood by disabled people with cognitive dysfunction. Because of that, I would like to share what I found out in case anyone else is in the same situation of being disabled with an insured spouse.

Basically, if you are disabled and have been on SSDI for two years, you are automatically eligible for Medicare Part A, no matter what your current insurance status. Part A is hospital coverage. If you currently have medical insurance through your former employer or via your spouse, Part A will be secondary to whatever you have now.

Medicare Part B is medical insurance. If you already have medical insurance through an old employer or your spouse, you can opt out of Part B without a penalty as long as your current insurance is comparable to what Part B offers. If you lose your current insurance, you can sign up for Part B at the standard premium rate as long as you do so within two months.

Medicare Part D is prescription drug coverage. If you already have a policy via a former employer or your spouse, you can skip Part D if your policy is "creditable", meaning that it provides coverage equal to or better than Medicare's. Check the benefit documents on your current policy to see if it is listed as creditable.

One really important thing to keep in mind: if you decide to sign up for a Part D plan, you may lose ALL of your current medical insurance provided by your former employer or your spouse. Do NOT make any changes to your coverage until you have spoken with a benefits administrator for your current insurance. Once you end employer-based medical insurance, you probably won't be able to ever get it back.

If you do find you have creditable insurance and don't need Medicare Part B, fill out the back of the card you have been sent stating that you don't want medical insurance and mail it using the postage-paid envelope they provide. You must do this PRIOR to the date your coverage is scheduled to begin. You will be sent a new card later on that says you have Medicare Part A only.

I am pleased to report that I do have creditable insurance via my spouse's employer. I found a CMS (Centers for Medicare and Medicaid Services) statement to that effect that I will keep in a safe place so that I have proof should Medicare screw up and try to penalize me for not taking Part B or D right now. I really am very lucky.

I feel like a freakin' genius right now. Not bad for someone who often has a 30 second attention span and can't remember what she said five minutes ago. I rock Medicare.