EXTENDED MEDICARE COVERAGE
Life recently became simpler for disabled Social Security (SS) beneficiaries who want to return to work without losing Medicare coverage. Effective October 1, 2000, Medicare's extended period of eligibility (EPE) during a transition back to work jumped from 39 months to 93 months. Add Medicare's 9-month trial work period (TWP) to the 93-month EPE, and you reach 8.5 years of Medicare coverage for disabled SS beneficiaries who return to work.
During the EPE period, beneficiaries are eligible for coverage under Medicare Part A (hospital) and Part B (medical). Most people pay no premium for Part A, but must pay a small monthly premium for Part B. Once the EPE period ends, a beneficiary who continues to have a disabling condition can purchase Medicare Part A and Part B. The one caveat is that you cannot purchase Part B without purchasing Part A.
The new law applies to any disabled beneficiary whose EPE began after June 1997. In some cases the new law may apply to people whose EPE began before July 1997, depending on an evaluation of the following factors: disability status, last day of TWP, participation in substantial gainful activity (SGA), and first month of SGA following TWP.
Even after a successful return to work, some beneficiaries may find it difficult to pay Medicare premiums after the EPE ends. They may be eligible for the Qualified Disabled and Working Individuals (QDWI) Program, which helps pay for Medicare Part A if the beneficiary is under age 65; continues to have a disabling impairment; is currently enrolled in Medicare Part A; has limited income; has resources worth less than $4,000 for an individual/$6,000 for a couple, not counting residence, usually one car, and certain insurance; and is not otherwise eligible for Medicaid.
Social Security has two outstanding Web sites that map out employment-related provisions of Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). One site, www.ssa.gov/work/ResourcesToolkit/redbook.html, provides a brief but comprehensive overview of SSDI/SSI issues. The other, www.ssa.gov/pubs/redbook99.htm, contains a full copy of SS's "Redbook on Work Incentives: A Summary Guide to Social Security and Supplemental Security Income Work Incentives for People With Disabilities."
You can expect to see more changes surface under the umbrella of the Ticket to Work and Work Incentives Improvement Act that became law in December 1999. We will provide updates as they become available. Meanwhile, call your local PVA national service officer if you have any questions. You may also call Medicare's toll-free number, (800) 633-4227.
As you work through the Medicare maze, you are bound to run up against unfamiliar words and terms. Help is at hand. Medicare provides a comprehensive glossary on its Web site to help translate Medicare lingo. The glossary's address is www.medicare.gov/Glossary/Results_AllLetters.asp#Content.
We suggest you keep a copy for easy reference.
The Veterans Benefits Department provides this section to update readers on significant benefit changes or resources. These brief updates are intended only to familiarize you with topics appearing in this section. Your local national service officer (NSO) is available to provide more in-depth information.
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|Title Annotation:||updated Medicare benefit coverage|
|Publication:||PN - Paraplegia News|
|Date:||Dec 1, 2000|
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