YOU ASK:

Do I get prescription drug coverage with disability SSDI?

WE ANSWER:

You don't directly get prescription drug coverage with Social Security Disability Insurance. Social Security will mainly pay disability benefits when you have sufficiently proved that you are indeed disabled, based on the eligibility criteria they have.

However, if you have been receiving disability benefit payments for 24 months, you may become eligible under Medicare and receive medical benefits, including prescription drug coverage. You need to sign up for this coverage. You are required to sign up within the period covered by three months prior to your 25th month receiving Social Security disability benefits up to the three months after your 25th month. Confusing? This just means that you can sign up between the 22nd month to the 28th month that you are receiving Social Security benefits. You need to do this. Otherwise, you may also need to pay a penalty.

The Medicare benefits provided include:

  • Medicare Part A benefits (covering standard expenses during hospitalization)
  • Medicare Part B (covering mainly outpatient services and other expenses not covered by Medicare Part A
  • Medicare Part D (covering prescription drug coverage)
  • Other optional plans such as Medicaid

This is not just for the disabled beneficiary, but also for his dependents. Also, the prescription drug coverage covers not just generic prescription drugs but also brand-name medications.

With the implementation of Obama's Health Care reform bill, the prescription medicine coverage has been expanded and improved. Please note that Medicare prescription drugs only pay up to $2,700 and will start up again when the prescription drug expenses reach $6,154. What will happen is that the government will try to plug in the amount in between by providing rebates and discounts for the brand-name medicines.

In 2010, the beneficiary will receive a rebate of $250 when his medication expenses exceed $2,700. Come 2011, discounts of up to 50% will be given for medicines, particularly brand-name drugs.

Eligibility for prescription drug coverage is virtually for everyone who is under Medicare. This does not change no matter one's level of income, health and present medication costs. Medicare insurance provides you with a helpful addition, since you will surely have to spend for medical treatments and drugs during your recovery period.

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