Social Security Questions and Answers

vacationbound

Thank You Steven-Sorry for replying so late, was on a Christmas visit with family since my last post. Happy New Year to you and may you be blessed with many fortunes and faith.

inmate4232010

Thank you so much for answering all of our questions.  I hope your wife and family are doing well. 

I have been on SSI since Oct 1st but was backdated to my original diagnosis in 2010.  I am currently paying for my own private insurance with the usual deductible and 20% out of pocket.  Like everyone else I have some outstanding medical bills I am currently making payments on.  My 24 month waiting period is up this April and I plan on applying for Medicare.

Here's the question:  Will Medicare pay the outstanding (out of pocket) balances from the date of original diagnosis (date SSI was backdated)?

I have been making payments on the outstanding balances and wonder if I should discontinue making my payments until my Medicare kicks in.  I would notify the providers that payment will come from Medicare.  Should I also notify my primary insurance, or would this cause problems with future payments to my providers?

Thank you again for your continued support for all of us in the face of dealing with your beautiful wife's own diagnosis and treatment.   

scuttlers

No, Medicare will not pay for medical bills incurred before Medicare is in effect.

inmate4232010

Thanks Scuttlers.....Wow that was a quick response!  I thought i was the only one still awake at this hour.

Does it just start the day it "starts"?  Do you know if Medicare becomes your primary or does my private insurance stay the primary.

Thanks again for the quick response! 

scuttlers

I believe Medicare becomes the primary. This is how my private insurance has it detailed in their Master Plan. Specifically details that when Medicare goes into effect, the currant insurance will be secondary payor (if I continue coverage). You may want to check your Master Plan regarding this. Mine is on-line.

Chickadee

Inmate are you on SSI or SSDI? Medicare = SSDI. SSI = Medicaid. Very important distinction.

NMM

Fearless:

 No SGA is usually sometime of earned income.  

 Steven

NMM

Inmate

If you are on SSI you ar enot on medicare.  Medicare only comes with DIB what most people call SSDI.

For instance people on SSI in CA get medical.

But medicare starts 2 year after you are found disabled.  So you would not have coverage before that.  But if you were found disabled but it took 5 years to get that decision then it would go back 3 years.

I would let yor insurance company know if  that is a requirment in the plan documents.

Steven

NMM

Or what Scutt and Chick said...LOL

NMM

Don't feel like starting a new thread...

But sometimes when I have a bad day at work it really sucks...because my best friend, my wife, the one person who can always make me smile, has a bigger problem and I feel selfish talking about my bad day.

That is one of the most frustrating things....but even thinking that makes me feel selfish.

Sorry..just had to say it...back to our regular scheduled program.

Steven

Faith316

Steven,

You are most certainly not selfish.  Whenever I read this thread, I always think how awesome it is that you are taking time to help so many women here despite all that is going on in your own life.  That speaks volumes for what kind of person you must be.  I hope your wife is doing ok.

Chickadee

You do a good job of drawing this thread back to its purpose when it wanders a bit.



As for bad days, don't think we folks on here don't curse a blue streak at times, at this miserable fate. In fact I've been feeling one coming on for a couple days now and so far only my dogs have had to run for cover. Miserable +*^=+*=+=*^*^#^%€£+€+*>*^ back pain. Ok I didn't spell it out but you get it.



Feel free to let your freak flag fly when you need to, it's cathartic. f word and all.

inmate4232010

Steven.....I think we all expect and are given permission to feel the pressure of this disease from time to time (or more often).  It is especially important for those caregivers to do the same and not feel at all selfish.  You are going through this with your wife and have shown yourself to be anything but selfish for her and those of us you continue to help on this board.  So vent when you need to, we are ready with both ears open!

I am on SSI, not permanent disability SSDI.  Do I have that distinction correct?  The information given said coverage after 2 years from diagnosis.  I guess that means any bills incurred before my 2 year mark will be mine and my private insurance responsibility. 

Thanks for the clarification!

Here's to a good day for both you and your wife! 

cycle-path

Steven, I don't have SSI issues but I started reading your posts from the first time you came here and I continue to read this thread because I'm so impressed with what you're doing for the women on BCO who are helped by your advice. I'm also impressed that the suggestion to do this came from your wife. I wish I could do something for the two of you.

You said that when you have problems, the idea of telling your wife about it seems selfish in light of what she's going through. Consider, though, that part of what she wants now is normalcy -- and part of normalcy is playing the support role for one's partner.

So while I don't think you should just dump on your wife, do consider allowing her to continue in her role as supporter to you during this time. If you really do have the type of loving relationship with her that you've portrayed here -- and I don't doubt that you do -- I expect she'll actually appreciate being asked and allowed to support you now.

Best of luck to you. I think about you often. 

Chickadee

SSI is Supplemental Security Income and is awarded based on income level. While you applied for it through the SS office it is administered by your state. If you are certain that SSI is your program then you will not be enrolled in Medicare based on that program. Medicaid through the state is the health program tied to SSI.



SSDI, the social security disability insurance program, is based on work history and the amount you receive can be higher or lower dependent on your earnings history. SSDI recipients are eligible for Medicare 2 years from date of disability.



I think you would benefit from a visit to your local Social Security office to clarify just what your status is. I dont know of any insurance program that will cover bills incurred before actual qualification and enrollment.

Joycesches00

Steven

I am 63 yrs old just diagnosed with DCIS(reoccurence from 1999, Lumpdecty and radiation) now a Mastectomy I saw a Oncologist and she wants to put me on Aromatse inhibitors.  I know they are very disabiling drugs.  I am on STD right now but I am due to return to work 1/20.  My job is very stressful, and demanding.  I am not sure I will be able to do it.  I can not stand for the 8 hrs required.  I do not know if going back to work to try and see what I can do will hurt my appling for Disability as in Social Security Disabilty.  My Mastectomy will need more treatments also. Advice is needed I am getting very depressed 

Chickadee

AI's aren't always disabling. Some of us tolerate them quite well. I was 18 months on Aromasin and didn't miss a beat. It's such a tough decision. If you go back to work now and then decide you are unable to continue to meet the demands of your job, the only difference will be your date of disability. You will need to bridge some sort of insurance coverage until you are entitled to Medicare. Can you retire from your company with health insurance?



As for myself I decided to pull the plug last year and it turned out to be the right decision. I've had serious physical challenges this year. I miss work but I know I can't give 100% or even 75%.



On the plus side if you decide you are ready and this is financially possible, you won't regret being able to take care of yourself.

Joycesches00

I am not concerned as much about the insurance I am lucky to be on my husbands for maybe 2 yrs The Aromasin was one of the ones recommended to me but the downsides may be to much especially the loss of bone.  I am fighting for the last 20yrs arthritis and do not know if this will really do me in.  Did you end up on SSD or how are you suviving.  I will be going back to a very stressful job.  Mostly due to Company management.  My job has been moved in the 6 weeks I was out and I would be required to stand for 8 hours with managment watching me all day.  I have worked for this Company for 38 yrs but the stress is growing.  I am trying to make aleast 65 (2 more yrs) but no sur I can.  My doctor filled out a Back to work form stating I need a chair or stool,  I don't know how this will go..Today they decided to have a shift bid while I am out ,even though I ststed I would return on the 20th of Jan.  It is so unfair to me.  I am the longest and oldest employee doing this job and there is no appreciation after 38 yrs of service.  I become very depressed to think about this., plus my illness witch I believe is related to this stress. I worry about the future alot. 

Joycesches00

Did th Aromasin make you stop in 18 months and are you on ssdisability

Chickadee

I had progression so it was time to move on. 18 months was a good progression free interval. With 38 years service surely you are eligible for retirement of some sort. I too am covered by my husbands insurance. I decided last April when I experienced progression to apply for SSDI. It made perfect sense to me to obtain now the much higher monthly benefit then the reduced one at age 62. I'm 60. In addition my husband is entitled to that higher benefit upon my death so I feel like I'm providing for him. I receive monthly the same amount I would if I waited until full retirement age. if you don't have one around, go to the SSA website and ask them to send you your earnings estimate.



In August this year I suffered a bad collapsed vertebra and I know now if I hadn't applied then I would be now.

Joycesches00

I kinow this is stupid on my part but what is Progression and how does that effect you.  Thank you for giving me the heads up about SSDI.  I am not sure how to go about applying for it and what is neccessary to qualify.  The retirement I would recieve after 38 yrs of service is oly about 200 or 300 amonth, not enough to servive on.  I would br begging for money

scuttlers

Joyce, you haven't given your stage so can't tell if you could possibly qualify for SSDI. You could possibly apply for LTD IF your company has that benefit. You could file for FMLA which would give you 12 weeks, but possibly without income.

Joycesches00

I am aware of the LTD I am already on STD I am Stage 1 DCIS  2nd time and a Mastectomy I am just worried about the near future as I try to go back to work and now having more Meds to take and hoping I can make it really.  I am just trying to see the future I already have bad bones and I hope I will not be to debilatated  but if I do I am hoping I can find help I have other problems as controled Epilepsy but I deal with this since I was 13

scuttlers

I believe that, being Stage I DCIS, it probably would not be approved if you apply for SSDI. I am so sorry about your arthritis issues and the epilepsy. It has been very difficult for you, I am sure. So sorry to not be helpful.

PlantLover

Joyce - I think you may be able to qualify for SSDI for reasons other than your breast cancer.  I'm sure Steven we be along soon to help answer your questions.

Cylce-path - I've also been reading this thread since it was started.  I also don't currently have a need for SSI but marked it as my favorite so that I could keep up with the info, just in case.  I had skipped the last couple of pages but caught up on this thread last night.

Dear Steven - I started writing this post last night but couldn't finish it because I got too emotional.  To my husband and through tears, I read your original post and this ...

Don't feel like starting a new thread...

But sometimes when I have a bad day at work it really sucks...because my best friend, my wife, the one person who can always make me smile, has a bigger problem and I feel selfish talking about my bad day.

That is one of the most frustrating things....but even thinking that makes me feel selfish.

Sorry..just had to say it...back to our regular scheduled program.

We completely understand that kind of love.  My husband I were married about a month before my Stage III diagnosis and it's been a wonderful and challenging two years.  He can always make me smile ... always! 

I have to say I agree with what cycle-path wrote.  I'm sure your wife wants to be there for you too.  If she's at all like me, she probably gets so tired of feeling like everything is always about her.  So you see, in reality, you'll be helping her by letting her help you - not selfish at all!!!

I can't tell you how much I admire both of you ... her for suggesting you start this thread and you for keeping up with it considering all that you guys are dealing with.  What a unselfish and caring thing to do! 

Steven, not that there's ever a good age to be dealing with this crap, especially Stage IV, your wife is much too young.  It truly breaks my heart every time I read your original post ... 36 with two small children and a loving and happy relationship with you ... I HATE CANCER!!!!! 

You and your wife will be in my thoughts.  Good luck with the new treatment!  Okay, I have to stop now, I'm crying again.

Chickadee

38 years of steady work. I'm guessing a lot of that was work that didnt pay into SSA. I'm so sorry it's such a small amount and I can see why you are holding on to work.

scuttlers

Is the 2-300 a month just the retirement from the "company" and does not include Social Security? Or is that figure SS benefits? Interesting question Chickadee. If the figure is SS, then SSDI would not provide much either as it is also based on what was paid into the system.



And I agree, you may qualify using the other issues that you have. It probably not be a quick process (as with Stage IV, or IBC etc.). I think the average wait for "non compassionate" filings is around 18 months. Unfortunately, you have worked with the epilepsy diagnosis for decades - and with that history, it would be difficult to get a positive decision. (we have a dear friend who is a thalamide baby, think flippers for arms - he was denied disability because he worked at a position for 40 years. He was layed off and could not find another position anywhere.) and with arthritis, it again is very difficult.



Really, I think the whole situation just sucks - and I am so sorry you are having to deal with this.

MariaB2010

I just want to say thank you for doing this God bless you and your wife!

thriceblessed

I hope today is a good day for both you and your wife, and that the Xeloda is the key to shrinking those liver mets. 

LTD-related SSDI questions- 

1. How soon must a person file for SSDI when on LTD?  The LTD plan requires filing, but I don't know if there's a deadline by when one has to apply.

2. Can it be beneficial to wait until later rather than earlier to apply?  Concerned about being forced into Medicare coverage 2 yrs from SSDI benefit start-date.

Joycesches00

Know that is not true all 38 payed into SSA It was work for a major Car rental

and you must understand I hope and pray I will not need to go out.  I am not trying to work the system .  I just want to know what could happen down the way to me and how to handle it if needed and thing go down hill for me. The 200 or 300 a month is the really bad Pension plan and No 401K