Approved for SSDI, onset 6-04, Medicare eligibility 11-06? Will medicare back pay charge incurred 1-07?

Answer 1

Well, this was interesting, so I took advantage of this question to call my baby sister - a practicing SSDI attorney in OH.

She says, the wait for Medicare eligibility is 29 months. So, if you have a judgement giving you back SSDI benefits, the Medicare eligibility kicks in 29 months after the effective date of judgement. At that time, technically, prior medical charges WOULD be covered by medicare, but you have to ask the provider to REBILL them to medicare, otherwise Medicare has no idea they're out there. She says, if you don't have the medicare card yet, you can use your notice of judgement instead.

IN YOUR CASE, it's going to depend on the dates. 11/06 is EXACTLY 29 months. If the judgement was for 06/01/04 and the date of service is 11/02/06, then yes, it will be covered, IF the provider re-bills medicare. If hte judgement is effective 06/03/04, however, and the date of service is 11/02/06, then no.

Hope that helps.

Answer 2

If you are under 65 and approved for SSDI, then you are most likely not eligible for Medicaid....SSDI is disability payments you receive because one, you have worked enough credits in your life to receive it, and two, your assets and spouses income are over the allowalbe limit for you to receive SSI (which is a form of disability that you can get if you haven't worked enough credits, and you are in a very low income bracket).

Medicaid is available for people who get SSI, and some who get SSDI. After having Medicaid for for 2 years, some states choose to automatically give you Medicare, provided that you've worked enough credits to be eligible if you were 65. Medicaid retroacts 3 months prior to the date of eligibility if you ask them to retro it when you apply.

Medicare itself does NOT retroact. You are only eligible for medical expenses being paid beginning the month you started Medicare. Also, it greatly depends on the charge incurred...depends on if it was a Medicare allowable expense. But in your post, you said you were eligible for Medicare effective 11/06, and the charge was incurred on 01/07...making the charge come after the eligibility date, and therefore there is no back pay charge.

Answer 3

You might want to check around for clinics in your area. They have a sliding scale basis and the usual cost is $10.00-$15.00 per visit. Many of them have pharmacies and dispense medications for $5.00 or less. If the docs perscribe medications and se meets the low inclome guidlines most pharmaceutical companies will send the medications to her either to her home or to her doctors office, about 3 months at a time. The applications can be printed from their website and the doc would need to sign the prescription for them. Also Wal Mart does have a solution in the form of $4.00 RX's. Again you need to apply for it. They can even be mailed to the patient if the pharmacy is far from you. Publix in the Southern States has a free meds program too. Could your mom have COBRA'd out of the insurance plan?

Answer 4

if you were approved for ssdi you should be getting medi-cade. if so you are covered from date of first application. im assuming you mean 1-06 instead of 07.

Answer 5

I thought Medicare was retroactive go ing back as far as three months IF REQUESTED.

Answer 6

If it's an allowable charge, sure, since you were eligible.

Answer 7

If I were you I would be contacting Medicare.

Answer 8

No. Your Medicare benefits will not have begun at that time.