Can a disabled Teacher qualify for Medicare (Health Insurance) before age 65?
Social Security pays benefits to people who cannot work because they have a medical condition that is expected to last at least one year or result in death. (ssa.gov) However, as a teacher and a member of CalSTRS you don’t pay into Social Security so you probably wouldn’t get SSDI. Check with CalSTRS, Medicare or Attorney’s.
CalSTRS Publications & Medicare & Social Security
The CalSTRS Disability Benefits Guide states that you may qualify for long-term disability benefits if you have a medical condition that will prevent you from working for at least a year. STRS Member Handbook Your CalSTRS retirement benefit or Medicare benefit will not be reduced because of these provisions in Social Security law Nolo’s Guide to Social Security Disability
My wife just was informed that she will be on permanent disability from CalStrs. She has Young Onset Parkinson’s. She is 54 years old. Her payments will start on Sept 15th. She worked for close to 10 years in something outside of teaching so she must have close to the 40 quarters and also she paid into Medicare in each of her checks as a teacher.
Is she eligible for Medicare?
***This is all quite complex… Here’s the page on Social Security’s website about how many quarters you actually need. Check our webpage on Social Security Disability and we’ve linked to attorney’s that can help you sort through this confusion. Please also visit your local CalSTRS office. Here’s their office locator.
If you are not getting employer paid medical coverage and want to check out the individual & family market, including ObamaCare Subsidies, click here.
Try this Medicare eligibility calculator.
It is difficult to figure all this out. We have heard that she will be eligible for Medicare after two years of being “officially disabled.” We have heard that she would be eligible for Medicare if she was eligible for Social Security disability.
***Yes, that is correct, if one qualifies for Social Security Disability.
Our Webpage on Social Security Disability – I don’t see that you have anything to lose by applying. If you do get benefits, they would offset what you are getting from STRS per page 7 of the STRS manual.
The Question in your situation, is can she get both Medicare and CalSTRS disability?
***Appears to be yes, as there is an offset – reduction see citation above. What medical coverage does she have now?
She went on Medical leave on Feb 1st.
We want to stick with the CalStrs disability payments since they are larger.
***That’s fine, it’s just an offset.
What is the three pronged test for Disability Eligibility?
To meet the definition of disabled as established for CalSTRS in the California Education Code, you must have a medically determined physical or mental impairment that is permanent or expected to last at least 12 continuous months. The impairment must prevent you from performing:
- Your usual duties with or without reasonable accommodation from your employer.
- Duties of a comparable level to your usual duties, which you are qualified for or can become qualified for in a reasonable period of time with education, training or experience.
- Employment at a comparable level at which you can earn at least 66 2/3 percent of your final compensation. Cal STRS Disability Benefits * Calstrs.com *
This looks to me, and of course please go ahead and check with competent legal counsel to be a 3 prong test. See the Miller 3 prong Test for Obscenity. That is to be disabled you must meet all 3 of the above requirements. That is, if you can make more than you earned before, but voluntarily elect not to, then your not disabled.
Links & Resources
* 24103. (a) The member shall provide medical documentation substantiating the impairment qualifying the member for the disability retirement under this part.
How does one live on 2/3 rds of their prior income
or a max of $31,500 earned + the Disability Benefit?
You can earn income after you begin receiving a disability Coverage B benefit. You can teach under certain employer conditions, but you are not allowed to earn CalSTRS service credit or contribute to CalSTRS while receiving a disability retirement benefit. Your earnings from all types of employment, including self-employment, are subject to an earnings limit, unless you are participating in an approved CalSTRS rehabilitation plan.
CalSTRS retirement benefits will be reduced dollar for dollar by the total amount of earnings from all employment in excess of the 12-month calendar year limit. You will be required to provide CalSTRS with an annual report of your gross earnings from all employment. The Employment Development Department and your employer will verify your reported earnings.
The 2019 calendar year earnings limit is $31,500. The limit is determined early each calendar year. This amount is different from the service retirement earnings limit. Member Handbook Page 110 *
Links & Resources
Why you need and how to get disability insurance – Nerd Wallet
Check out the Disability Needs Calculators below.
You’ll find that there is a limit to how much you can get while disabled.
If you’re disabled, you don’t have to drive to work, buy lunches out, nice clothes, etc.
You generally don’t need the same level of income when you are disabled as you did when you were working. In fact, you can typically only purchase disability insurance for about 60% of your predisability income.
Consider the following reductions in spending that you could make if you became disabled:
- Commuting expenses. If you drive to work, you can probably assume it costs you $0.50 per mile.
- Workday lunches and breaks. If you eat out every day and buy the occasional latte, you could easily save $10 to $30 per day when you are not working.
- Work clothes. Being unable to go to work can save thousands of dollars per year in clothing expenses.
- Discontinued activities. It’s sad, but life on disability may not include the vacations you’re used to. On the bright side, you’ll have fewer expenses. You may even generate income from selling those jet skis, ATVs, and other toys.
- Downsizing. Most of us can make cuts in our budget if we have to. Moving to a smaller, perhaps one-story house may even be a good idea. Motley Fool.com
Nolo's Guide to Social Security Disability
We do have a reference copy in our office