You Could Lose Your SSDI Benefits If You Decline Medicare Part A

How SSDI Binds You to Medicare

Part A and SSDI
Refusing Medicare Part A could mean losing your disability benefits.. Huntstock/Brand X Pictures/Getty Images

Medicare is not only for those older than 65 years of age. It is a benefit offered to those who have disabilities, assuming they meet certain disability criteria. The problem is you may not want Medicare if you could get cheaper health insurance elsewhere. Saying no to Medicare, however, could have serious repercussions.

What Disabilities Qualify You for Medicare?

If you fall into one of these disability categories, you may be eligible for Medicare even if you are younger than 65 years old.

  • You have amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig's disease.
  • You have end-stage kidney disease (ESRD) that requires dialysis or a kidney transplant.
  • You receive disability benefits through the Railroad Retirement Board (RRB).
  • You receive Social Security Disability Insurance (SSDI).

Paying Into the System

People who qualify for Medicare have paid for that benefit, both through Medicare and Social Security taxes. The number of years you have paid the federal government through your paycheck determines your eligibility for both programs. These dollars are intended to safeguard these entitlement benefits when you need them in the future.

The Cost of Medicare

While Medicare offers health care to the disabled, it is not free. You must pay premiums for the different parts.

  • Premiums must be paid for Part A, if someone has not worked 40 quarters of taxed employment.
  • Everyone pays premiums for Part B, an amount determined by your income.
  • If you want prescription drug coverage, you will pay premiums for Part D as well.

In lieu of these options, you may pick a Medicare Advantage plan. Medicare Advantage plans include everything that Part A and Part B cover and may include Part D coverage if you choose. Again, these plans come with a premium.

Other health plan costs include deductibles, coinsurance, and copayments.

When Other Insurance Costs Less than Medicare 

You may find that other insurance options, like an Obamacare plan, may be less expensive for you than Medicare. The problem is that you are not allowed to have both Medicare and an Obamacare plan at the same time.

Alternatively, you may have affordable health coverage offered through your spouse's health plan or you may be eligible for health care based on your military experience, whether through the VA or TRICARE.

In these cases, you may be tempted to decline Medicare in favor of another insurance. After all, no one wants to pay two premiums if they do not have to.

Declining Part A Coverage  

You need to know that there could be repercussions if you decline Part A coverage, especially if you are on SSDI. Medicare Part A is linked closely with Social Security. Declining your Medicare Part A benefits relinquishes your rights to your Social Security benefits as well.

This not only means losing future income, money that you had paid into the system.

It also means you will need to pay back any money you were received from Social Security through that date.

Declining Part B Coverage

If you decline Part B coverage, you may be faced with late penalties when you sign up at a later time. This will not cause you to lose your Social Security benefits.

What You Should Do

Most people get Part A for free. If this is the case, it is usually in your best interest to enroll and continue Medicare coverage to secure your Social Security benefits.

Continue Reading