As we were discussing in part I, there are a multitude of considerations individuals need to take into account following the receipt of a favorable decision. One of the more important considerations is how one will be able to remain in treatment and what health insurance will be covering your treatment as you move forward.
Medicare insurance entitlement (just like a senior citizen who has reached retirement age) is available once one has been collecting Social Security Disability Insurance (SSDI) for a period of 24 months (in their 25th month of eligibility to a check). Accepting Medicare is not required (even though one may see the premium automatically taken out: this can be cancelled with a simple phone call). However, foregoing Medicare during this enrollment period can result in an increased cost should one choose to enroll at a later date. If one is already receiving state Medicaid (referred to as Mainecare in Maine, MassHealth in Massachusetts and simply Medicaid in New Hampshire), one may be entitled to apply with their local Department of Human Services office or, in Massachusetts, the Department of Transitional Assistance, so as to request that the State pay the Medicare premium. In this way, one can have both Medicare and Medicaid health insurance, with the state picking up the tab for both: in this way, Medicare pays first and Medicaid becomes secondary insurance.
Should, however, one lose their Medicaid upon receipt of a favorable decision (which happens if one’s monthly entitlement to SSDI is too high), another health insurance option available is through the Affordable Care Act (ACA), otherwise known as Obamacare. The discontinuance of Medicaid as a result of one’s SSDI income would be considered a qualifying event, allowing for enrollment at that time for ACA insurance.