Shouild my husband apply first for disability benefits or retirement benefits?

Mmhsfo asked...

I have two questions. My husband is turning 66 next week. Currently he works full time and has not filed for his Social Security benefits or Medicare (he goes to the VA for his medical care). He has just been diagnosed with Stage IV cancer and the prognosis is that he has 8-10 months left, with aggressive chemo. He has received radiation treatment and is about to begin chemo. I believe his condition qualifies for a fast-track disability benefits claim -- should we go forward with that or file for his retirement benefits instead? I am concerned that if we don't file for the correct benefit first that the processing of his claim for either benefit will be delayed.

My other question regards Medicare -- do I understand correctly that we have 30 days (from the date of application?) to choose what insurance plans we need for the various coverages? Can he be denied coverage because of his diagnosis?

Thanks in advance for any information or direction on how to proceed.

Expert Answer

I'm terribly sorry to hear about your husband's diagnosis. I hope that his Social Security benefits and Medicare coverage can make these next months somewhat easier for you both.

As for whether your husband should file for Social Security retirement benefits or fast-track disability benefits, he can collect whichever is higher but not both. Because he is reaching full retirement age (66) next week, he is entitled to full retirement benefits. That amount would be the same as his disability benefits (assuming he would be eligible for them). Even the fast-track disability qualifying process takes more paperwork, and possibly more time, than retirement benefits, so it's probably better for him to claim retirement benefits. Call Social Security at 800-772-1213 right away and make an appointment -- usually an appointment can be given to you within just a few days -- to go to your local Social Security office to sign up for retirement benefits. When you speak to the person on the phone at Social Security, double-check with them whether they think there would be any benefit to your husband to apply for disability instead. They will also tell you what documents he needs to bring to the appointment.

When your husband goes the local Social Security office, he'll also be able to sign up for Medicare coverage. He'll receive Medicare Part A (inpatient hospital and nursing facility coverage, as well as hospice), which is free, and Medicare Part B (outpatient care, such as doctor and clinic care and laboratory work). Most people pay a monthly fee for Medicare Part B, and because he waited a year after turning 65 before he's applying for Medicare, he may have to pay a slightly higher amount. If he's had health insurance through his employer, however, he won't have to pay the higher amount.

Once your husband is enrolled in Medicare Part B, he can also buy a private supplemental Medigap insurance policy that pays some of the costs of care that Medicare doesn't (deductibles, copayments, and the 20% of doctors' bills that Medicare doesn't pay). Because he will be buying a policy within 6 months of first enrolling in Medicare Part B, he will be allowed to buy any Medigap policy sold where you live, regardless of his diagnosis.

One reminder about VA medical coverage and Medicare. For any particular medical service, your husband can receive it from wither the VA system or have Medicare cover it from a non-VA but Medicare-participating provider. However, neither Medicare nor a Medigap policy will help pay for care your husband receives from the VA, and the VA will not help pay for care your husband receives outside the VA system.