I am a 59-year-old female and in June of 2022, I was diagnosed with stage III metastatic breast cancer. A non-profit cancer program in my state qualified me under Medicaid because I was unemployed, and I was referred to a local cancer facility for treatment. I have had a radical mastectomy with chemotherapy and will be starting radiation next week.
Friends tell me I am crazy not to get my Social Security Disability because I need the income. Social Security has said I am eligible for disability (based on work credits) and the amount I can collect will be $2,015.
My question: If I can qualify for Social Security Disability because I am unable to work due to my breast cancer, will I be able to keep my Medicaid benefits? At present, I am not paying anything for my cancer treatments. Thank you for any advice you may have!
- Terri, a confused Baby Boomer
Many Americans believe that qualifying for Social Security Disability Insurance benefits (SSDI) can be the answer when you cannot work due to a serious illness. Your friends do not know the Medicaid or Medicare rules and can steer you in the wrong direction!
To qualify for Medicaid, one must meet certain income requirements in the state where one resides. If you make $1 too much -- I repeat, $1 too much -- you can lose your Medicaid benefits.
Terri, you are just beginning your radiation treatments and currently do not have to pay for anything because you have been blessed by qualifying for Medicaid. You could lose your precious Medicaid benefits if your $2,015 monthly SSDI check is too much income to keep you qualified for Medicaid in the state where you live.
Once you lose your Medicaid benefits, Medicaid will not be paying the cancer facility or any other healthcare facility or provider. Unless you can qualify for and afford to pay for other health insurance, you will have to pay 100% for your cancer treatment. Then your troubles will really begin!
When someone qualifies for SSDI, it will take 24 months to qualify for Medicare, which will begin on the 25th month. (Chapter 1 of the Medicare Survival Guide Advanced edition explains how to enroll in Medicare the correct way.)
My advice is to wait and apply for SSDI benefits until after you have finished all your cancer treatments and are released with a clean bill of health. I would not want you to put the mental and financial burden on yourself or your family because you are worrying about how to pay for your cancer treatments.
If you are no longer receiving cancer treatments that are covered by Medicaid when you are 62, apply for your early Social Security benefits, rather than SSDI.
At 62, you can receive 75% of your Social Security amount. (You would not receive 100% of your Social Security benefit until you reach your full retirement age (FRA).)
At 65, apply for Original Medicare online at www.ssa.gov and apply for a Medicare Supplement with a standalone Medicare Part D plan or enroll in a Medicare Advantage plan with Part D. Always confirm that your cancer facility and/or medical providers accept the Medicare Advantage plan you are enrolling in.
With Original Medicare, the Medicare recipient can make as much money as needed and not lose medical benefits, unlike Medicaid benefits which you can lose if you make too much money.
Toni King is an author and columnist on Medicare and health insurance issues. She spent more than 27 years as a top sales leader in the field. If you have a Medicare question, email email@example.com or call 832-519-8664. You can now visit www.seniorresource.com/medicare-moments to listen to her Medicare Moments podcasts and get other information for boomers/seniors.