Medicare Qualification

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eric84

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I have a family close friend who is likely going to get an ALS diagnosis and we are trying to find out if she will qualify for Medicare. She has been a stay at home mom so she has not worked but her husband has worked and they have paid social security through his work. All the websites make it sound like medicare is a given if you have an ALS diagnosis but it isn't clear if it will still be valid if only the spouse has worked. Does anyone have any insight into this? It seems like it should be an obvious question but I've been looking for hours without a clear answer. Thanks in advance!
 

lgelb

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Unfortunately, no, not if she has not worked in the last ten years. Her Medicare eligibility hinges on her eligibility for SSDI. If she has worked some during that time, she can go to the SSA site and calculate whether she is eligible for SSDI. If she is, she will also be eligible for Medicare immediately as well.

If she has coverage through her husband's work, she should continue it, or if he leaves to care for her, he could take COBRA and keep her coverage that way for a while, though the premiums are often pricey. What kind of ACA coverage he and/or she is eligible for depends on their resources, income, and State.
 

eric84

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Thanks for the information. I am surprised as it seems like from a tax standpoint they are being treated as a single individual since they file jointly and thus she is effectively paying into the system as well. I'll let them know though :(
 

JimInVA

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For the last 15 years of my PALS working life, she worked with me in our small Mom and Pop company business. We decided that we'd write one check... to me... when we'd pull personal money out of the company for payroll purposes. We filed taxes jointly, so no big deal. I actually verified this as okay with a client who was an enrolled tax preparer and CPA. When Darcey was finally diagnosed with ALS, we immediately applied for SSA benefits for her. It didn't matter that we both worked together day in and day out. Darcey even winked at the person at the SSA counter and said, "he took home the money and got the benefits... you know, I got to sleep with the boss!" There were some laughs but no SSA compensation with the 0 payments from her into the system over the previous 10 years.

So I kept her on as a company employee and co-owner an she continued to participate in our company's group insurance through Anthem... until she turned 65. It was not until the day she turned 65 that she became eligible for benefits that were calculated from her entire work experience (in regard to retirement) and earned Medicare. I will say that Medicare was easy to work with during the next 11 months that Darcey remained living.

My best...

Jim
 
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