I have Medicare Part A and B since 06/01/2006 because of disability. My husband retired on 4/1/2024, and I now have no other coverage except for Medicare Parts A and B because I missed open enrollment for insurance coverage. Note: SS dropped SSI and changed it to straight SS. Please help.
Answered by 16 licensed agents
You do have coverage under Medicare. Which is important, but the concern is that if you experience a life-changing event, it could be costly because Medicare is an 80-20 plan. Also, do you have a drug plan? If not, you'll be assessed a penalty once you sign up. You do have two options: one is buying a Medicare supplement like Plan G or N, or waiting until AEP from October 15 through December 7, for 2026. I would reach out to a licensed agent to review the right plan.
When someone has a change in coverage, they qualify for a Special Election Period’ so they can make a change outside of the annual enrollment periods. Find a Broker and get the coverage you need.
I have Medicare Part A and B since 06/01/2006 because of disability. My husband retired on 4/1/2024, and I now have no other coverage except for Medicare Parts A and B because I missed open enrollment for insurance coverage. Note: SS dropped SSI and changed it to straight SS. Please help. You get a Medigap plan to help with the out pocket cost.
Get with a local agent to see if there is a SEP (Special Election Period) available in your area county. Also there may be a Chronic Special Needs plan available in your county that may allow you to join during the lockout period. You could also call Medicare.
There are different options to look at to see what you may qualify for, even a possible special enrollment period. To be able to help I would need more information on your situation, but definitely would be able to get you answers.
I assume you are still under age 65 and that you implied that you had Medicare Part A&B PLUS your husband's employer provided healthcare (as additional coverage). Since he's now retired, and you've lost his coverage, you may have "guaranteed rights" to purchase additional private medicare supplemental insurance (like a medicare supplement), as long as you can prove that you had creditable coverage from his employer all this time. Any insurance company is going to want additional written evidence to prove this information. I suggest you reach out to a local agent directly for more details and instruction.
You have insurance coverage. It's called Medicare. What you don't have is coverage for the 20% that Medicare doesn't pay. That SSI changed to SS is not relevant to this issue, unless the total gross monthly income for you and your spouse, qualifies for Medicaid in your state. Otherwise, you have 2 choices to cover the 20%. You can see if you qualify for a Medicare supplement, based on your health, and ability to pay the monthly premium. Or you can wait til the annual Enrollment, which starts on Oct 15th and sign up for a Medicare Advantage plan. None have health underwriting, and most have a $0 monthly premium and a built-in Rx plan. But since you have gone over 63 days without an Rx plan, you will pay the LEP (late enrollment penalty) on a monthly basis, for the rest of your life.
During AEP you may pick you a health plan and if you are on Medi-Cal then you can opt for a Dual Special Needs Plan or possibly a Chronic Condition Needs plan. At this point you have a gap in coverage. Not sure what you mean regarding what you noted at the end of your question. Reach out to me and we will work with you to take care of it.
Unfortunately, you will have to wait for Medicare's. Annual election period starting October 7th to enroll in a plan that will make it effective. January 1, 2026. Your only other option is to see if you can pass health underwriting questions on a medicare supplement.
For clarity, when exactly did you lose SSI? You have 3 months to join a Medicare Advantage Plan from either the date you lost Medicaid or the date you were notified that you're no longer eligible, whichever is later.
Also, regardless if you lost SSI, if your disability is due to one or more of the chronic conditions recognized by Centers for Medicare & Medicaid Services (CMS), you would qualify to join a Chronic Condition Special Needs Plans (C-SNPs). Those chronic conditions are:
Chronic alcohol and other dependence
Certain autoimmune disorders
Cancer (excluding pre-cancer conditions)
Certain cardiovascular disorders
Chronic heart failure
Dementia
Diabetes mellitus
End-stage liver disease
End-Stage Renal Disease (ESRD) requiring dialysis (any mode of dialysis)
Certain severe hematologic disorders
HIV/AIDS
Certain chronic lung disorders
Certain chronic and disabling mental health conditions
Annual Enrollment Period for Medicare changes starts on Oct 15 for plan year beginning the following Jan 1. I definitely recommend discussing your options with a licensed Medicare broker. You can also check with CMS (or work with a licensed Medicare broker) to determine if you may be eligible for a "SEP" - special enrollment period because of your husband's retirement or your own transfer from SSDI to SS.
Under normal circumstances, Medicare Part A and B considered to be a good coverage especially if enhanced by Medicare Supplement and Prescription Drug Plan or alternatively used as Medicare Advantage Plan. Your dissatisfaction with your current coverage may stem from the timing of your husband’s retirement. When his group health insurance ended, you may have also lost any secondary insurance you previously had through his employer, leaving gaps in your overall coverage. You'll have an opportunity to enroll into Medicare Advantage plan in the upcoming Annual Enrollment Period October 15 to December 7 with the effective day of January 1, 2026. You may have a guaranteed enrollment privilege to sign up for Medicare Supplement when you turn 65.
Hi there! Gosh that is a lot of changes. I know how frustrating this can all be. You can get a Medicare plan outside of enrollment if you've had a special enrollment period like losing coverage. Usually, you have 63 days to get new coverage. I'm happy to help I believe my contact info is avail on this site... but, whomever you contact should be able to get you Advantage plan with a special enrollment period. You should do it quickly as after that 63 days you may have to wait if you are disabled you won't make thru underwriting for a Medicare supplement. I hope this helps. I'm happy to try and resolve. Sincerely
