Amyotrophic Lateral Sclerosis (ALS), also known as Lou Gehrig’s disease, is a progressive and fatal disease that affects the nerve cells that control voluntary muscles. If you have been diagnosed with ALS, you may be wondering about your Medicare options. Fortunately, if you receive Social Security Disability Insurance (SSDI) or a railroad disability annuity check, you are eligible for automatic enrollment into Medicare the first month you receive your disability benefits.

In this article, we will provide a comprehensive guide on how to enroll in Medicare if you have ALS. We will cover the basics of Medicare, the enrollment process, and common questions and concerns for those with ALS.

Understanding Medicare

What is Medicare? Medicare is a federal health insurance program that provides coverage to people who are 65 or older, as well as to people with certain disabilities or medical conditions. The program is divided into four parts: A, B, C, and D.

What does Medicare Part A cover? Medicare Part A covers hospital stays, hospice care, and some home health care services.

What does Medicare Part B cover? Medicare Part B covers doctor visits, outpatient care, and some preventive services.

What does Medicare Part C cover? Medicare Part C, also known as Medicare Advantage, is a way to receive Medicare benefits through a private insurance company.

What does Medicare Part D cover? Medicare Part D covers prescription drug costs.

Enrolling in Medicare with ALS

How do I enroll in Medicare if I have ALS? If you receive SSDI or a railroad disability annuity check, you will be automatically enrolled in Medicare the first month you receive your disability benefits. You will receive a Medicare card in the mail about three months before your coverage starts.

What if I don’t receive SSDI or a railroad disability annuity check? If you do not receive SSDI or a railroad disability annuity check, you can still enroll in Medicare. You can enroll during the Initial Enrollment Period, which is the seven-month period that starts three months before your 65th birthday month and ends three months after your 65th birthday month.

What if I miss the Initial Enrollment Period? If you miss the Initial Enrollment Period, you can enroll during the General Enrollment Period, which is from January 1 to March 31 each year. 

What if I have a Medicare Advantage Plan? If you have a Medicare Advantage Plan and are diagnosed with ALS, you can continue to receive your Medicare benefits through your plan. However, you may also be eligible for additional benefits and services through Medicare, so it’s important to speak with a Medicare representative about your options.

Frequently Asked Questions

What if I need help paying for Medicare? If you have limited income and resources, you may be eligible for assistance paying for Medicare. You can apply for the Medicare Savings Programs, which can help pay for Medicare premiums, deductibles, and co-insurance.

What if I need home health care services? If you need home health care services, Medicare Part A and Part B may cover these services. However, there are certain requirements that must be met in order for the services to be covered.

Can I change my Medicare coverage if I have ALS? Yes, you can change your Medicare coverage during the Annual Enrollment Period, which is from October 15 to December 7 each year. You can switch from Original Medicare to a Medicare Advantage Plan or vice versa, as well as make changes to your Medicare Part D prescription drug coverage.

Can I receive hospice care if I have ALS? Yes, Medicare Part A covers hospice care for people with ALS who meet certain criteria. Hospice care provides support and comfort for people who are in the final stages of a terminal illness.

Enrolling in Medicare if you have ALS can seem overwhelming, but it’s important to understand your options and take advantage of the benefits available to you. If you receive SSDI or a railroad disability annuity check, you will be automatically enrolled in Medicare. If you don’t receive disability benefits, you can enroll during the Initial Enrollment Period or the General Enrollment Period. Additionally, if you have a Medicare Advantage Plan, you may be eligible for additional benefits and services through Medicare.

If you have any questions or concerns about enrolling in Medicare with ALS, it’s important to speak with a Medicare agent like the experts at Plan Medicare. They can provide you with more information about your options and help you make the best decision for your individual needs.