Medicare enrollment while on Social Security disability

Dear Toni: My husband has reached his 24th month of being on Social Security disability, which qualifies him for Medicare. His disability is due to a severe case of Parkinson’s. On Aug. 1, his Medicare Parts A and B will begin, but he is only 64. I am not sure what he should do when he turns 65 in March.

With Paul’s serious Parkinson’s affecting his health, I am concerned about which Medicare option is best for him. Should he enroll in a Medicare Advantage plan or a supplement?

Because his Parkinson’s medications are expensive, I am concerned about whether he will enter the Medicare prescription drug doughnut hole. Can you please advise us on Paul’s best Medicare option? — Sheila from El Paso, Texas

Dear Sheila: Enrolling in the correct Medicare and Part D prescription drug plan when someone has a serious health condition can be extremely complicated.

People on Social Security disability and qualifying for Medicare Parts A and B need to be aware that there are two Medicare enrollment times:

Enrolling in Medicare under 65: When a person’s 24th month of Social Security disability passes, they are automatically enrolled in Medicare, which begins on the first day of the 25th month. That is the case with Paul’s Medicare, even though he has not yet turned 65.

In Texas, people under 65 and eligible for Medicare will have only one Medicare supplement plan that they are eligible for with most Medicare supplement insurance companies: Plan A. This supplement plan works directly with original Medicare and has more out-of-pocket costs than Medicare supplement G. Different states have different supplement plans available to those under 65.

When someone is under 65 and enrolling in Medicare for the first time, we advise the new Medicare client to ask their medical professionals and facilities which Medicare Advantage plans they accept.

Medicare Advantage plans help cover the costs that Medicare does not pay for. The Medicare Advantage plan will have deductibles, copays or other out-of-pocket costs that the Medicare enrollee will have to pay.

When under 65, this may be an option to consider since original Medicare is out of pocket. Always verify that your health care professionals and facilities accept and will bill the Medicare Advantage plan you have picked.

Turning 65 and on Social Security disability: The good news is that when Paul turns 65, he will have a second Medicare supplement enrollment period, which is called the Medigap/Medicare supplement open enrollment period. He will not have to answer any health questions to enroll in a supplement, because he has turned 65 — the same as anyone who is just turning 65 and has received both Medicare Parts A and B.

People on Social Security disability will qualify for Medicare supplement Plans A through N during the six-month period that begins the month of their 65th birthday.

Toni King is an author and columnist on Medicare and health insurance issues. If you have a Medicare question, email info@tonisays.com or call 832-519-8664.