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Jul 8, 2008

The Twenty-Four Month Waiting Period For Medicare

A person who is approved for Disability Insurance Benefits under Title II of the Social Security Act faces two waiting periods. First, there is a five month waiting period until cash benefits begin. This works out to be more than a six month waiting period in fact, since the five months must be full months and because benefits for a month are not paid until after the month has ended. If you become disabled on July 2 2008, you cannot count July as one of the five months. The date of first entitlement to cash benefits would be January 2009, but the check for January 2009 would not arrive until well into February, 2009. Your waiting period in this example would be almost seven months.

The second waiting period is for Medicare. This is a 24 month waiting period after the entitlement to cash benefits begins. Thus, the claimant who became disabled on July 2, 2008 would not become eligible for Medicare until January 2011.

My clients often ask why they have to endure these waiting periods. What is the rationale behind it? They crave some logic to explain these long waits. The only answer I can give them is that it saves money. There is no other explanation. There is no logic.

Both waiting periods are controversial. There have recently been rumblings about eliminating them.

Someone at Social Security decided to do a study to see how many of those people enduring that 24 month waiting period were covered by Medicaid. (Remember, Medicaid is the poverty program and Medicare is the non-poverty program. If you are on SSI, you are categorically eligible for Medicaid. Got that?) My guess is that someone, perhaps the Commissioner, perhaps someone in the White House, perhaps someone in Congress, was looking for ammunition to fight off a push to end the 24 month waiting period. If that was the goal, it looks like the statistical study will not help. The study is presented in a confusing format, but it looks like only 11% of those in the 24 month waiting period for Medicare are on SSI and thus categorically eligible for Medicaid. Of the other 89%, undoubtedly some are covered by health care insurance provided to them at no cost by their former employer and others are able to come up with the money to keep paying their health care insurance premiums. Others are eligible to receive care from the Department of Veterans Affairs (VA). My best guess (and I am in a much better position to guess about this than anyone at Social Security, the White House or Congress) would be that around half of the people who are in the 24 month waiting period have no Medicare, no VA medical care and no health care insurance, even though they have been acknowledged as disabled by their government. Does this sound right? Is it defensible?

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