One of the most upside-down things about health care in the United States is that it's largely tied to employment. Most insured Americans have employer-provided health insurance policies. So, what happens when you can't work anymore because of injury or illness?
Unfortunately, there are thousands of disabled South Carolinians who are stuck in a two-year wait for Medicare benefits.
While we would love to see federal policy change, the best we can do right now is explain what you can expect if you apply for Social Security Disability Insurance (SSDI) in South Carolina.
SSDI recipients are eligible for Medicare
Once you qualify for and have been receiving disability benefits for two years, you will be automatically enrolled in Medicare, the same health care program that supports retired Americans.
You will likely have to pay a monthly premium for the coverage, but can apply for assistance from the state of South Carolina for certain health care expenses you can't afford under your Medicare plan.
What to do during the two-year wait
Until you have been receiving SSDI benefits for two years, you will not qualify for Medicare benefits. There is little you can do during the waiting period, which our South Carolina SSDI attorneys know is excruciating. We can help you brainstorm options. Some might include:
- COBRA. If you had en employer-supported health care plan, you can usually continue that coverage even after you're no longer working. The trouble is that these plans are often very expensive. There could be federal, state or charitable funds available to help you offset the expense.
- Private insurance. If COBRA is too expensive or you do not qualify for it, you might be able to get private health insurance. Historically, the same health issues that qualified you for disability would be considered pre-existing conditions and make it nearly impossible to qualify for private insurance benefits. However, the Affordable Care Act created a "high-risk pool" program. If you have been uninsured for more than six months, you can apply for insurance through this government-run resource and cannot be denied benefits because of a pre-existing condition.
- More options in 2014. Once the Affordable Care Act is fully implemented in January 2014, you will be able to go through state-run South Carolina insurance exchange to get private health insurance and will be eligible for certain subsidies and tax credits if you can't afford the full cost of a plan.
- Free clinics and emergency rooms. If you do not have health insurance and can't get it during your two-year wait, visit free clinics for regular health care needs and emergency rooms for major medical emergencies related to your disability.
If you are unable to work because of injury or illness, don't wait to apply for Social Security Disability Insurance and don't accept an initial denial . The sooner you qualify for disability benefits , the sooner you can get the Medicare coverage you need. Let the South Carolina SSDI team at George Sink, P.A. Injury Lawyers help you prepare your application or appeal. Contact our office with questions about your rights and the process.