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Seniors

Ways We Can Help

  1. Advocate on your behalf with the U.S. Social Security Administration and the Center for Medicare and Medicaid Services
  2. Provide assistance in securing benefits. retroactive benefits and Medicare coverage
  3. Inquire about the status of your disability claim, appeals, and billing
  4. Assist with obtaining new or replacement social security cards

Social Security and Medicare represent our promise to seniors of a secure retirement. As 76 million baby boomers approach retirement, our office will continue to work to help retirees receive the financial security and health coverage they deserve. For more information or to request assistance, contact our office at 925-933-2660.

Social Security

Over 95,000 seniors receive Social Security benefits in California’s 11th Congressional District. The U.S. Social Security Administration (SSA) delivers services through its network of over 1,400 offices throughout the country. They are committed to delivering Social Security services to the public. The Social Security Administration provides information about:

  • Eligibility for SSA programs

  • Applying for retirement benefits

  • Calculating benefit amounts

  • Applying for Supplemental Security Income (SSI).

What if I do not want to apply online?

You may contact the Social Security Administration (SSA) at 1(800) 772-1213 or TTY: 1(800) 325-0778. An agent can help you find your local office, send you the correct forms, and answer questions that you may have.
 

Do I qualify for Social Security Disability?

You must be unable to perform work of any kind and your disability must be expected to last for at least one year or result in death. You must also have earned enough "credits" – at least 5 years of work in the 10 year period prior to the onset date for your disability. In addition, you must be fully insured under Social Security, which means you must have worked for 40 quarters (10 years). The 5 years of work prior to becoming disabled counts in calculating the 40 quarters. The SSA receives numerous applications for disability benefits. Because of the large volume of applications, it can take a long period of time to receive a decision.
 

What can I do if my application for disability is denied?

If your application is denied, you may appeal the decision. You must file the Request for Reconsideration, a complete review of your claim. This will be completed by a staff member in your local office. This person must not be the same person that made the original decision in your claim. If you still disagree with the new decision from the Request for Reconsideration, you will file an appeal that will go to your local Office of Hearings and Appeals. The appeal will be reviewed by an Administrative Law Judge and may take several months. If you get denied again, you may appeal. This appeal will go to the Appeals Council and will take about two years to be decided. If you receive disability benefits, the benefits won't begin until the sixth full month after the date the Social Security Administration decides the disability began. In addition, you must wait two years before you qualify for medical coverage.

You can file an appeal or read more about Social Security’s definition of a “disability” online with the Social Security Administration’s Internet Appeal.

 

Medicare

How do I apply for Medicare?

It’s convenient, quick and easy. There’s no need to drive to a local Social Security office or wait for an appointment with a Social Security representative. Medicare is managed by the Centers for Medicare and Medicaid Services (CMS). Social Security works with CMS by enrolling people in Medicare.

For more information on how to apply, click here.

 

Do I qualify for Medicare?

You qualify at age 65 or older if:

  • You are a U.S. citizen or a permanent legal resident; and
  • You or your spouse has worked long enough to be eligible for Social Security or railroad retirement benefits — usually having earned 40 credits from about 10 years of work — even if you are not yet receiving these benefits; or
  • You or your spouse is a government employee or retiree who has not paid into Social Security but has paid Medicare payroll taxes while working.


Note: You can qualify for Medicare on your spouse's work record if he or she is at least age 62 and you are at least age 65. You also may qualify on the work record of a divorced or deceased spouse. Following the Supreme Court's ruling on the Defense of Marriage Act in June 2013, people in same-sex marriages may qualify on their spouse's work record if they live in the state where they were wed or in another state that recognizes same-sex marriage, or if they are civilian or military employees of the federal government. It's currently unclear whether same-sex couples outside of these categories have the same rights — but if you're in this position, you should apply anyway.

You qualify under age 65 if:

  • You have been entitled to Social Security disability benefits for at least 24 months (which need not be consecutive); or
  • You receive a disability pension from the Railroad Retirement Board and meet certain conditions; or
  • You have Lou Gehrig's disease (amyotrophic lateral sclerosis), which qualifies you immediately; or
  • You have permanent kidney failure requiring regular dialysis or a kidney transplant — and you or your spouse has paid Social Security taxes for a certain length of time, depending on your age.

If you do not qualify on your own or your spouse's work record:

Provided that you're a U.S. citizen or have been a legal resident for at least five years, you can still get Medicare benefits at age 65 or older by:

  • Paying premiums for Part A (hospital insurance). If you have fewer than 30 work credits, you pay the maximum premium, $426 a month in 2014. If you have 30 to 39 credits, you pay less, $234 a month in 2014. If you continue working until you gain 40 credits, you will no longer pay these premiums.
  • Paying the same monthly premiums for Part B, which covers doctor visits and other outpatient services, as other enrollees pay.
  • Paying the same monthly premium for Part D prescription drug coverage as others enrolled in the drug plan you choose.

You can enroll in Part B without buying Part A. But if you buy into A, you also must enroll in B. You can get Part D if you're enrolled in either A or B.

Most people receive annual statements from Social Security saying whether they're yet eligible on their work records. If you don't get these statements, or are still not sure if you qualify, call Social Security at 1-800-772-1213.

 

Filing a claim, complaint, or appeal:

How do I file a complaint (also called a "grievance")?

Find out how you can file a complaint (also called a "grievance") if you have a concern about the quality of care or other services you get from a Medicare provider. Contact your State Health Insurance Assistance Program (SHIP) for local, personalized Medicare counseling.

How do I file a claim?

Get information on how and when to file a claim for your Medicare bills (sometimes called "Medicare billing"). You should only need to file a claim in very rare cases.

How do I check the status of a claim?

Learn about several ways to check the status of a Medicare claim, like MyMedicare.gov, your Medicare Summary Notice (MSN), your Explanation of Benefits (EOB), Medicare's Blue Button, or by contacting your Medicare Advantage plan or Medicare Prescription Drug Plan.

How do I file an appeal?

Learn how to appeal a coverage or payment decision made by Medicare, your Medicare health plan, Medicare Prescription Drug Plan or Medicare Medical Savings Account (MSA) Plan.

Your right to a fast appeal

Learn how to get a fast appeal for Medicare-covered services you get in a hospital, skilled nursing facility, home health agency, comprehensive outpatient rehabilitation facility, or hospice that are about to stop.

Your Medicare rights

Understand your Medicare options, rights, and protections.

Get Medicare forms

Access forms for permission to share your personal health information, filing an appeal, applying for Medicare, and requesting medical payment.