During an episode of the BoomX show, airing on KOMO radio each and every Saturday from 2:00 to 4:00, a listener called in with an interesting question. She is 58 and still works but has a health condition that is treated with, among other things, prescription drugs that cost over $30,000 per year. She wants to retire and asked what her options were.
3 possible ways to pay for high prescription drugs:
Washington State’s Health Insurance Exchange: Mandated by the Patient Protection and Affordable Care Act (Obomacare), the exchanges all Washingtonian’s affordable insurance. That’s right! Almost anyone can sign up for the coverage on the Exchange. Even if you are not medically indigent, you can still qualify for coverage. Just pay the full premium amount for the coverage they select. There is no pre-existing condition exclusion clause but you do have to enroll during open enrollment which is from November 1 to January 31 of each year. (There is also a special enrollment period for certain circumstances, such as losing your employee health insurance.)
Social Security Disability Income: I had not inquired but she was still working and younger than her full retirement age. Yet, she has a serious medical condition. In such cases, she may meet the requirements to qualify for Social Security Disability Income.
To qualify for SSDI, she must have a qualifying disability and have worked recently and enough hours.
Disability: Social Security considers and applicant disabled if:
- The applicant cannot do work that they did before;
- cannot adjust to other work because of a medical condition(s); and
- the disability has lasted or is expected to last for at least one year or to result in death.
Work Requirement: In 2015, for example, she earned one credit for each $1,220 of wages or self-employment income. When she earned $4,880, she would have earned your four credits for the year.
Generally, she needs 40 credits, 20 of which were earned in the last 10 years ending with the year you become disabled.
Medicare is a national health insurance program for Americans over age 65. But, you have to apply and pay premiums. Medicare has two “parts” that are relevant to prescriptions drugs: Part C or D.
Washington State Prescription Drug Program: a free prescription drug discount program for Washington residents. Although this program does not coordinate benefits with insurance or Medicaid, it can be used for prescription drugs not covered by your insurance. Check out the programs website.