ALS and medicare/SS was denied

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FOSKOI

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Hi, it's Farzaneh, I am 61 yo and I was diagnosed with ALS in Jan 2020. I am lucky to have my husband as caregiver, as I need help with all daily activities.
I worked all my life as IT LAN administrator and obtained the 40 credit to get medicare, though I became a homewife when my son was born in 2004.
I applied to get Medicare through SS disability, but my application was denied base on the fact that I have not worked in the past 10 years, with my last year of working being 2004. My ALS is progressing fast and it is unlikely that I will reach the 65 yo mark. I would even love to have just medicare without SS benefit, if there were a way..

I plan to apply for an appeal but:

Does anyone has suggestion on what I should write for a successfull appeal?

Thanks for your answers

Farzaneh
 

ShiftKicker

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Hi Farzaneh,

I am so sorry to welcome you here, but very glad you found us. I've moved your post to the general forum, as there are many people here who have experience with US insurance/coverage issues and will definitely be able to provide you input. We have a great group of people here, and hopefully folks will weigh in soon.
 

Nikki J

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I am sorry. I do not think you will be successful in an appeal though of course you can try. You could ask a medicare lawyer but I personally would not pay money to do so as I believe you will be told no. My sister also lacked current work credits as she had stayed home with her child and I have heard this happen to others as well. The rule is pretty clear unfortunately and I don’t know anyone who found a loophole. Of course you can take reduced social security at 62 but it doesn’t give access to medicare
 

lgelb

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Farzaneh, a sad welcome. My husband was in a similar situation and I have to agree with Nikki that your time and money are better spent elsewhere. I take it you do not qualify for Apple Health because of your husband's income? There is no asset test in WA, only household income. And I believe [check w/ an attorney] you can file as a"married, filing separately" on your tax return so as not to be his tax dependent, though he would pay more in taxes for your access to Apple Health. It might be worth it. You can also get tax credits by buying a plan through the WA State Exchange.

There are other federal programs you may qualify for depending on your income and assets.

Best,
Laurie
 

FOSKOI

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Thank you all for your input. I currently have HC insurance through my husband and caregiver, though he was hoping to retire if I could get medicare....
 

Nikki J

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You might want to explore your options- COBRA from your husband’s job though that is generally 18 months. There are some circumstances where it can be up to 36. Of course it is expensive. Another option besides Medicaid ( which I think is Applecare Laurie mentioned?) would be ACA. Depending on income you may get subsidies. I know someone who couldn’t get early medicare who did that. ACA seems to be safe for at least this political cycle
 

JimInVA

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My wife and I had our own business. She wrote one check to me that covered both of our wages. She'd have fun telling folks that she didn't bring home a paycheck but that she did get to sleep with the boss. Unfortunately, when Johns Hopkins told her to go get her early access to SS benefits (available because SS is fast tracked for ALS), she was denied. Reason? She had no salary history (or SS/Medicare contributions) during the previous 10 years. She was 59, then, and was unable to get SS until she turned 65.
 

MToole

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Jim, thank you for sharing your story
what did you end up doing for insurance.
I'm not familiar with details except that you need to have insurance.
check with the people at your ALS clinic
 

lgelb

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Yes, Medicaid in WA State is AppleHealth.

ACA rates (the Exchange I mentioned) is certainly the next option if you don't qualify for AppleHealth, and you can get tax credits based on income to defray part of the cost. By visiting wahealthplanfinder.org, you can input info about your household and see your plan options/cost.
 

JimInVA

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@MToole - We had owned our own business and had an Anthem Blue Cross/Blue Shield Group plan. I can't imagine where we would have been without good insurance. Ours had a $4,000 up front deductible before insurance kicked in... but on some years, we met that in the first month.

My best...

Jim
 
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