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Medicare coverage for under 42 years old
Dec 11, 2009

Hello. First of all I would like to begin by thanking you all for your expertise and guidance. I am currently disabled and receiving payments from the state of Mo. The department of Health and Senior Services has prepaid my monthly spenddown for the last year and a half of my illness but in January 2010 that amount will be adjusted to half the amount. I become eligible for Medicare in September 2010.

How would having Medicare effect my coverage?

Will I have to continue paying a spenddown plus a Medicare premium?

Or would I only have the Medicare premium to pay each month? Also I'm hoping to return to the workforce within the first half of the year,if my strength permits. How would employment effect my medicare coverage?

And my last question concerns Medicare eligibility, once I am eligible for Medicare can I lose my eligible status?

And how does fulltime employment affect eligibility?

Thanks again for your help. Any and all of your guidance would be greatly appreciated.

Thank you all for fighting the good fight. Sincerely, D

Response from Ms. Franzoi

Since you state that you will become eligible for Medicare in September 2010, I am assuming that you have qualified for Social Security Disability Insurance (SSDI) and will have had 24 months of SSDI coverage by September 2010, thus making you eligible for Medicare. There are 3 Medicare parts: Medicare Part A (Hospital Insurance), Medicare Part B (Medical Insurance) and Medicare Part D (Outpatient Prescription Drugs). Part A is premium free while Parts B and D require a premium. There are also Medicare Advantage Plans often referred to as Medicare Part C. Once you become eligible for Medicare, you must enroll in Parts A and B to avoid penalties for enrolling late. You have two choices - enroll in A, B and D or enroll in A and B and elect a Medicare Advanatage Plan. Medicare Parts A, B and D would provide you with medical, hospital and prescription drug coverage. You would also be eligible to buy a Medicare wrap policy to supplement the Medicare Part A and B benefits. However, if you go the route of electing a Medicare Advantage Plan, a wrap policy would be of no value.

Under Medicare, if you were to reutrn to work, you could be entitled to receive up to 93 months of Medicare coverage during a trial work period as long as you still have the disabling impairment. This provision allows you to continue to have health insurance while you return to the work place.

You can also find more information and some Q&A's at or by calling Medicare at 1-800-633-4227.

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