ALS (Amyotrophic Lateral Sclerosis aka Lou Gehrig disease) is a chronic condition with associated special Medicare enrollment rights and plans.
What is ALS as per Medicare?
ALS, or Amyotrophic Lateral Sclerosis aka Lou Gehrig disease, is a neurodegenerative disease that progressively affects nerve cells in the brain and the spinal cord.
How does having ALS impact my Medicare benefits?
ALS patients may be eligible to enroll in Special Needs Plans (SNPs) focused on ALS.
It is also advisable to look at Medicare Advantage Plans which limit out of pocket expenses though they also limit the network of facilities and physicians.
For those over 65, Medicare Supplement plans may help pay for deductibles, copays, and coinsurance.
Can I enroll into Medicare sooner if I have ALS?
Just like ESRD, ALS patients may be eligible to enroll in Medicare regardless of age.
Do I need to enroll in a Special Needs Plan? Are there any ALS-specific plans?
There are Special Needs Plans (SNPs) focused on ALS and similar conditions. You may enroll into one if they are available in your area.
I am already on Medicaid and have ALS. Now what? Who pays for what?
Between Medicare and Medicaid, Medicare pays first. If you are a dual eligible, you would generally have broad coverage for any health condition, including ALS.
You may also want to look at Special Needs Plans (SNPs) which may be offered in your area and enroll in one best suited for your needs.
How does having ALS impact my Medicare costs?
ALS patients may typically use one of two ways to limit their costs.
For those under or over 65, enrolling in a Medicare Advantage Plan will limit their out-of-pocket costs, though it will also limit them to the plan’s network.
For those 65 or over, Medicare Supplement plans may be a good option as these plans will help pay for deductibles, copays, and coinsurance.
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Last Updated: 08-09-2019