When it comes to insurance options, you might be unsure if Medicare is your best bet. Turning down Medicare in favor of a less expensive health insurance choice can be tempting. So, you may be wondering, “Can I refuse Medicare on SSDI?”
You cannot opt out of Part A coverage while receiving Social Security Disability Insurance (SSDI) unless you are willing to repay all of the SSDI payments that you have received, which means that you will most likely be required to keep it even if there is coverage available through an employer insurance policy held by a spouse. You can drop your Part B coverage if your employer provides it.
Keep reading below for more information.
What Conditions Make You Eligible for Medicare?
Even if you are under 65 years old, if you fit into one of the following handicap categories, you might be qualified for Medicare.
● You suffer from Amyotrophic Lateral Sclerosis (ALS).
● You need dialysis or a kidney transplant because of End-Stage Renal Disease (ESRD).
● Disability benefits are paid to you by the Railroad Retirement Board (RRB).
● You’re covered by Social Security Disability Insurance (SSDI).
Putting Money into the System
Medicare is a benefit that has been paid for by those who are eligible. In addition to determining your eligibility for the healthcare program, the number of years you or your spouse have paid income taxes to the federal government also affects how much you will receive. These taxes are being paid with the intention of preserving entitlement benefits for you in the future.
Medicare’s Price
Medicare does provide health care for the disabled, but it is not free. Each component has its own premium that must be paid.
If a person or their spouse has not been employed for at least 40 quarters, or 10 years, of taxable work, premiums for Part A (hospital insurance) should be paid.
Everyone must pay Part B (medical insurance) premiums, and the amount is based on your income.
You must also pay Part D premiums if you would like prescription drug coverage.
One alternative to these choices is a Medicare Advantage plan. All of Parts A and B are covered by Medicare Advantage plans, and if you desire, Part D coverage as well. You will have to pay a monthly payment for these packages, just like the other aspects of Medicare. Deductibles, coinsurance, and copayments are additional fees associated with health plans.
What Percentage of Social Security Is Withheld for Medicare?
Once you are eligible for Medicare and receive SSDI payments, Social Security will typically deduct money from your monthly benefit to cover your Medicare premiums. (You become a Medicare beneficiary sooner than you normally would (at age 65) because you were approved for SSDI, yet it will not cover your premiums.)
Most people have a monthly Part B premium of roughly $165 deducted by Social Security. Yet, because of an additional surcharge, the monthly premium for high-income people may be twice the normal amount.
Those individuals who don’t have enough work credits may additionally be required to contribute to the Part A premium.
Low-income disability users may obtain assistance from their states with Medicare premium payments, preventing Social Security from taking any money from their SSDI compensation. Medicare Savings Plans are the programs that assist with the payment of Medicare premiums.
To see if you qualify for assistance with your Medicare premiums, contact the social welfare agencies in your area.
Can I Refuse Medicare on SSDI?
You might discover that Medicare is more expensive for you compared to other insurance plans.
Although Affordable Care Act plans are enticing, you cannot use any portion of Medicare while enrolled in one. If your spouse has a health plan, you could enroll in it to receive health insurance. Even better, you might be qualified for healthcare benefits based on your military service, whether it be through TRICARE or the VA.
In these circumstances, you could be tempted to choose another insurance plan over Medicare. Nobody likes to make two payments if they do not need to. Yet, you must be aware that refusing Medicare could have negative consequences.
Refusing to Pay for Plan A Coverage
If you refuse Medicare (Plan A) on SSDI, you risk losing your Social Security benefits. Your retirement benefits or even SSDI benefits may be included in this. You will have to repay all Social Security payments you had received up until the point at which you declined Part A, in addition to losing your future Social Security income.
A district court in the United States issued a judgment on this same question back in 2001. Since they intended to stop paying into Part A and switch to coverage under the Federal Employees Health Benefits (FEHB) program, three federal employees filed a lawsuit against the government.
They also desired to continue receiving their Social Security benefits.
The solution was the 1965 bill that established both Social Security and Medicare. According to Judge Rosemary Collyer, “requiring a mechanism for Plaintiffs and others in their situation to “dis-enroll” would be contrary to congressional intent, which was to provide “mandatory” benefits under Medicare Part A for those receiving Social Security Retirement benefits.”
According to the judgment, Medicare Part A enrollment cannot be terminated without the individual also losing their Social Security benefits.
Refusing to Pay for Plan B Coverage
If you choose not to enroll in Part B coverage, you can incur late fees when you finally do. This won’t result in losing your Social Security benefits, unlike Part A. This is because Medicare Part B is tax-free.
Summary
Everyone would understand if you tried to minimize the cost of your medical care. And technically, you can refuse Medicare on SSDI. Having said that, if you receive SSDI, you shouldn’t refuse Medicare Part A. By legislation, the two programs are interdependent; declining one immediately rejects the other.
So, if you refused Medicare, you would lose your disability income in addition to your Medicare coverage! You can determine whether Medicare Part B is good for you, but be mindful that you might potentially have to pay late fees down the line.
