Nebraska Department of Insurance
THE NEBRASKA HEALTH INSURANCE INFORMATION, COUNSELING, AND ASSISTANCE (NICA) PROGRAM
MARCH 2001 NICA NEWS
QUESTIONS AND ANSWERS
Q. Does a beneficiary who retires and enrolls in Part B, but subsequently returns to work and cancels Part B, and then retires again and re-enrolls in Part B, have another Medigap open enrollment guarantee?A. No. Once a beneficiary enrolls in Part B, his/her Medigap open enrollment guarantee begins and cannot be reinstated. The beneficiary may be subject to a penalty from the Social Security Administration at the time of re-enrollment.
Q. Does Medicare cover not only those 65 and older, but the disabled too? What does Medicare cover for the disabled?
A. In 1972, Congress extended Medicare coverage to disabled people on Social Security Disability and those with end-stage renal disease (ESRD). In 1973, nearly 2 million persons with disabilities were enrolled in Medicare. Qualified persons will become eligible for Part A of Medicare once they have received Social Security or Railroad Retirement Board disability benefits for 24 months. If a disabled Medicare beneficiary who is under 65 years of age also wants Part B, which helps pay, when medically necessary, for the following services: outpatient doctor's services, and outpatient hospital care as well as physical and occupational therapists, and some home health care, they will have to pay the monthly premium as those do that are 65 years and older. Today, more than 5 million disabled Americans are at least enrolled in Medicare Part A.
As part of the Balanced Budget Act of 1997, states are required to provide Medicaid to qualified disabled working individuals which is known as the acronym, QDWI, for the purpose of paying Medicare Part A premiums. This program helps working individuals with disabilities whose income does not exceed 200% of the federal poverty level, who have limited financial resources and are not otherwise eligible for medical assistance. Disabled working individuals are eligible for the QDWI program based on income levels and financial resources.