Social Security / Disability / Veterans Benefits

Social Security Benefits

  • People that work and pay Social Security taxes earn credits toward Social Security benefits. The maximum amount of credits that can be earned per year is 4.
  • If you were born in 1929 or later, you need 40 credits to get retirement benefits, if you were born before 1929, you need fewer than 40 credits to get retirement benefits.
  • The majority of people earn more credits than needed in order to qualify for Social Security benefits.

Retirement Age

  • Full Retirement
    • 1937 or earlier-65
    • 1943-1954-66
    • 1960 or later-67
  • Early Retirement
    • Social Security benefits begin as early as age 62
    • Benefit amount will be less than the full retirement benefit

Medicare Benefits Covered

  • Part A
    • Hospital services (considered reasonable and medically necessary by Medicare)
    • Skilled nursing facility services
    • Hospice services
  • Part A and B
    • Home Health Care Services
      • Limited to “reasonable” and medically necessary services
      • Must be ordered by your physician and provided by a certified Medicare home health care agency
  • Part B
    • After yearly deductible, covers 80% of the Medicare approved amount
    • Some services not covered by part A or B
      • Acupuncture
      • Cosmetic surgery
      • Dental care
      • Orthopedic shoes
  • Part C
    • Medicare Advantage
    • Must be entitled to benefits under Part A and be enrolled in Part B
    • May include HMO’s, PPO’s, and private fee-for-service plans
  • Part D (Prescription drug plan)
    • No automatic enrollment
    • To enroll, must be eligible for Part A and B
    • “Initial enrollment period” is three months before you become eligible for Medicare until three months after you become eligible for Medicare
    • 2011 – annual max deductible was $310

Medicare Appeal Rights

  • Beneficiaries must receive written notice of termination of services, non-coverage, and cutbacks in coverage concerning Parts A and B
  • Parts A and B fee-for-service plans have five levels of appeals of the denial of payment of services
  • Most appeals must be written and filed within the number of days stated on the notice
  • Should be sent by certified mail, with a return receipt requested
  • Forms can be obtained from the Medicare website
  • Parts A and B
    • Should receive a Medicare Summary Notice every three months
    • Medicare Summary Notice lists all services you have had and whether Medicare paid for these services, also states your appeal rights
    • If your claim is denied, you may ask for an informal review
    • Informal review request must come within 120 days of the date of the decision
    • If denied again, you have 180 days from the date of the second denial to submit a written request for review
  • Supplemental Health Insurance (Medigap)
    • Private insurance used to supplement the gaps in Medicare coverage

Medicare gaps

  • Major Part A and B gaps
    • Inpatient hospital deductible
    • Hearing aids
    • Eyeglasses
    • Dental exams
    • Nonprescription drugs
    • Equipment considered non-medical or custodial
    • Home health care that is not skilled
    • Annual deductible for outpatient services
    • Routine care such as physicals

Old Age Pension

  • Provides a minimum level of income to needy residents 60 or older
  • To qualify, countable income must be less than the Old Age Pension standard of need-$699
  • Resources must be below $2,000 for a single person, $3,000 for a couple

Long Term Care Insurance

  • 25% of people that live to age 65 will eventually need some kind of long term care
  • Nursing home costs can exceed $60,000 per year
  • When considering purchasing long term care insurance look at: age, how benefits are paid, covered settings, length of coverage
  • Most policies are comprehensive, paying for home care, adult day care, assisted living facilities, nursing home care, hospice care  and respite care from a single pool of funds
  • There are three forms of traditional Long Term Care insurance: reimbursement, cash, and indemnity, with reimbursement being the most common form

Veterans Benefits

  • 2 programs provide benefits for disabled veterans
  • Veterans with service-connected disabilities might be entitled to compensation benefits regardless of resources or income. The amount will depend on level of the disability.
  • Dependents of veterans are also entitled to a benefit if the veteran is rated as being more than 30% disabled
  • Veterans with nonservice-connected disabilities may be entitled to a pension benefit, but only if permanently and totally disabled with limited income and assets
  • Surviving spouse and minor children may be eligible for pension benefits when a veteran dies, if the survivors’ incomes are below a certain level
  • Medical care is provided at Veterans Administration hospitals and clinics for service-related medical conditions
  • Veterans Administration may contribute to the cost of burial, headstone, or maker and a burial flag

Burial Benefits

  • Veterans that are discharged from active duty under conditions other than dishonorable and service members that die while on active duty might be eligible for VA burial and memorial benefits. Veteran’s spouses and dependent children of veterans and active duty service members also might be eligible
  • Reservists and National guard members, as well as their spouses and dependent children, are eligible if they were entitled to retirement pay at the time of death or if they would have been if they were over age 60
  • Burial in a VA national cemetery is available for eligible veterans and their spouses and dependents at no cost to the family