How does insurance work when you are retired? [before Medicare age]

Remember- I am asking about a disabled adult. If it’s SSDI (disability) it then triggers Medicare (after 2 yrs). Age doesn’t matter.

So with a closer look, SSI = Medicaid, SSDI = Medicare

Not sure which your person has.
Here’s an explanation of the difference.

The main difference between Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI) is that SSI is an entitlement program with no work-related requirements, whereas SSDI is an earned benefit that has work requirements to qualify. Both programs pay monthly benefits to people with disabilities.Oct 12, 2023

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SSI vs. SSDI: Similarities and Differences - NerdWallet

](https://www.nerdwallet.com/article/investing/social-security/ssi-vs-ssdi-difference#:~:text=The%20main%20difference%20between%20Supplemental,benefits%20to%20people%20with%20disabilities.)

If the surviving spouse was not covered under the deceased coverage at the time of death, the survivor loses the option for that coverage.

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Yes I am familiar with the difference. He has been declared disabled for purposes of the federal insurance but DK if the family ever successfully got him approved for SSI. So he probably has neither SSI nor SSDI.

Same here.

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H is retired fed employee collecting his annuity pension. Family medical premium is deducted from it every month. I have a survivor annuity of 55% of his, if he dies before me. My understanding is I will continue to be covered and have the funds deducted from the annuity, covering me and medical dependent. She has only been declared medical dependent by OPM, never by SS.

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We are both fed retirees but I am the one with the health insurance coverage for both of us. For this reason, H has survivor annuity of I think 25% (lowest you can have deducted) if I die first and this does also cover health insurance at the retiree fed rate.

Can this arrangement be set up for kids who have been designated disabled and are on the federal coverage?

You can only designate ONE person to get survivor annuity. In our case we designated me. You always reduce the annuity benefit if there is someone designate as surviving annuitant. The surviving spouse reduces it less than other survivors, even if there’s a significant age difference between retiree and spouse.

Once you designate the one survivor annuitant, I don’t believe you can swap it. We chose me because I don’t have much SS and much retirement and H is 15 years older than I am. I hope we can set things up to provide for D. We don’t have a plan. She’s appealing the SSD denial, but not sure if we may prevail.

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H is a fed employee and my recollection is that spouse must be covered under a FEHB medical plan AND the employee has elected a survivor annuity from the pension for the spouse. It’s not free retiree medical coverage, either. We will have to pay the regular active employee premium, which will cost us more than what we pay now, because H’s agency subsidizes part of the premium as a retention device (it worked) and that ends at retirement.

We will likely do Medicare as well because of my daily chemo. So, we buy a belt and suspenders because our current coverage does cover the meds ($100k+/year at the FEHB formulary rate, copay is $1800/year). The virtual 100% coverage between the two will compensate for the double premiums.

AND depending on your AGI, you may have an IRMAA subsidy to pay as well.
(ask me how I know?)

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My H’s former employer, fed govt, continues to pay a portion of our premiums so our portion is very reasonable and we do r need paper D RX drugs, not a supplemental nor a MEDI gap policy with our Medicare A&B. Yes, H has me receiving survivor annuity and premiums are deducted from annuity.

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@HImom please understand that the vast majority of seniors do not have the very generous medical coverage as retirees that your husband earned as a lifetime federal employee.

It’s wonderful for him…but most of us here aren’t in that situation.

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I do understand, was just trying to clarify for other fed workers, what was/may be possible, since sone have been posting various things here that differ.

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It also should give us pause to think what can be possible/afforded, to most everyone in the country, if people would just get over the cheap “socialism” shot, whenever the necessary societal funding is laid out.

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Early in my career I worked for a major employee benefits consulting firm. Clients were Fortune 500 or major employers in their geographic/industry areas. I worked in employee benefits communications, where we’d produce personalized statements showing benefits payable across the spectrum (medical. disability coverage, pension and 401k projections, as well as the company’s total cost for each person’s benefits package (40-50% of employee salary). Government agencies were the poor cousins.

Corporate America had far better salaries and benefits than government entities back then. Real pensions, retiree medical, LTD, etc. It’s a statement about how little corporations now care about their employees vs. the bottom line that the safety net has been shredded so badly.

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