Notes on 2024 WIP-C Webinar 5: Title 2 Protections and Medicare Coverage

Introduction to the Work Incentive Support Center (WISC)

• WISC provides training, credentialing, and support in work incentive planning.
• Part of the K. Lisa Yang and Hock E. Tan Institute on Employment and Disability at Cornell University's ILR School.

Topics Covered

• Work Activity Review and Medical Continuing Disability Review (CDR)
• Medicare basics and its connection to work
• 2025 Medicare premiums
• Medicare Part D Low Income Subsidy (LIS)

Special Work Protection for Title 2 Benefits

• SSA offers work incentives beyond IRWEs and Special Conditions.
• Includes protections in Continuing Disability Review, Work Activity Review, and Extended Period of Medicare Coverage.

Types of SSA Reviews

• Work Activity Review: Determines stage in return-to-work process and assesses if cessation or termination should occur.
• Medical CDR: Considers changes in medical condition; unfavorable results may lead to termination.

Triggering Work Activity Reviews

• Triggered by events improving work ability above SGA level, e.g., completion of a training program or end of the Trial Work Period (TWP).

Scheduling Medical CDRs

• Varies by disability severity:
  • MINE: CDR every 5-7 years
  • MIP: CDR every 3 years
  • MIE: CDR every 6-18 months

Ticket to Work CDR Protection

• Ticket must be assigned to an Employment Network or State VR agency.
• Protects against SSA initiating a medical CDR while the Ticket is in use.

Medicare Coverage

• Understanding rules and affordable options.
• Parts of Medicare:
  • Part A: Hospital Insurance
  • Part B: Medical Insurance
  • Part C: Medicare Advantage
  • Part D: Prescription Drug Plan
• Eligibility conditions vary for ALS and end-stage renal disease.

Extended Period of Medicare Coverage (EPMC)

• Continues for 93 months post-TWP if SSDI stops due to SGA.
• Medicare Wizard tool assists in analyzing coverage duration.

2025 Medicare Costs

• Part A: $285 or $518 monthly premium after EPMC.
• Part B: Standard premium of $185; deductible of $257.
• Part D: Variable monthly premium; deductible up to $590.

Medicare Savings Programs (MSPs)

• State-run programs help with Medicare costs for low-income individuals.
• Programs include QMB, SLMB, QI-1, and QDWI.

Medicaid and Medicare

• Medicaid acts as secondary insurance.
• Some Medicaid programs pay Medicare Part B premiums.

Medicare Part D Low Income Subsidy (LIS)

• Created to assist low-income individuals afford prescription drugs.
• Automatic enrollment for Medicaid, QMB, SLMB, and QI individuals.

Medicaid Buy-In Strategy

• Available in most states for workers with disabilities.
• Helps maintain LIS eligibility even with high earnings.

Summary

• Title 2 beneficiaries undergo regular medical CDRs and Work Activity Reviews.
• Medicare is maintainable after work, with careful cost planning and state assistance.

Homework

• Available on Moodle platform; optional but useful for clarification.

Contact Information

• K. Lisa Yang and Hock E. Tan Institute on Employment and Disability, Cornell University