Massachusetts Social Security Disability Lawyers Blog
December is the month when paperwork choices ripple into next year’s medical access and costs. If you receive Social Security Disability Insurance and are on Medicare, or will be eligible soon, Open Enrollment is your chance to make sure the plan you use on January 1 fits your medications, specialists, and budget. Because plan formularies and networks change every year, standing still can be as risky as making the wrong choice. Here is how to check your options, avoid common pitfalls, and protect your SSDI case from unintended consequences.
Start With Your Medications And Doctors
Begin by making a fresh list of your daily medications, including exact names, dosages, and the pharmacies you prefer. For each plan you are considering, check whether those drugs are covered, what tier they fall into, and whether prior authorization or step therapy is required. A plan that looks inexpensive on the premium can become costly if your key medication moves to a higher tier. Next, verify that your specialists and hospitals remain in-network for 2026. This is especially important for Bostonians receiving care at large systems such as MGB, BIDMC, or BMC; a slight network shift can mean longer travel time, fewer appointment options, or delays in procedures.
Explore Extra Help/Lis And Shine Counseling
Many SSDI recipients qualify for Medicare’s Extra Help program, also called Low-Income Subsidy (LIS), which reduces Part D premiums and copays. Even a modest change in income can affect eligibility, so revisit the application in December. Massachusetts also offers SHINE counseling, free, neutral guidance on plan choices. Booking a session can save hours of online comparison and help you spot enrollment traps. Bring your medication list, your doctors’ names, and any letters you received from your current plan about upcoming changes.
Coordinate SSDI, Medicare, And Other Benefits
If you also have MassHealth, a retiree plan, or COBRA, the order in which insurers pay affects out-of-pocket costs. Let us know about every card in your wallet; we can help you avoid situations where a pharmacy claims you are not covered because the systems do not agree on who is primary. If you are in the middle of an SSDI appeal or a Continuing Disability Review, keep copies of any plan change confirmations, and do not let care lapse because you switched networks. A gap in treatment can be misinterpreted as medical improvement when it was really an insurance hiccup.
Avoid Overpayments And Interruptions On January 1
Plan switches sometimes collide with Social Security’s payment systems. If your plan premiums will be deducted from your check, confirm that the correct amount will be taken for the right plan beginning in January. If you are working limited hours under a Trial Work Period or using an impairment-related work expense, continue logging your work and costs during December and January so that a later review does not result in an avoidable overpayment. When in doubt, report early and keep copies of anything you submit.
Keep Your Specialists And Medications Stable During Appeals
When we represent clients in SSDI appeals, we want your medical record to show consistent treatment with the specialists who know you best. Changing plans can interrupt that consistency. Before you click “enroll,” check whether your rheumatologist, neurologist, psychiatrist, or pain specialist will still see you on January 1 under the new plan’s network and authorization rules. If a plan change is unavoidable, schedule early January appointments now and ask providers what documentation they need to continue your therapy without a gap. We can also prepare letters explaining medical necessity if a plan demands prior authorization for care that has been stable all year.
How We Help SSDI Clients In December
At Jeffrey Glassman Injury Lawyers, our role is to keep your benefits path smooth while we fight your disability case. We help clients compare plans with an eye toward the conditions and medications most important to their claims, coordinate records so your new plan receives timely referrals and authorizations, and troubleshoot pharmacy or billing issues that arise during the changeover. If a plan’s decision threatens your access to medication or therapy, we work with your providers to pursue exceptions and appeals. Have questions about how a plan change might interact with your SSDI claim or appeal? Call (617) 777-7777 or use our online contact form for a free consultation. We handle SSDI claims statewide.