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When should I enroll in Medicare if I have a disability?
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If you become eligible for Medicare because of a disability and have been receiving Social Security Disability Insurance (SSDI) or railroad disability annuity checks for 24 months, you should automatically be enrolled in both Medicare Parts A and B at the start of your 25th month.
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- Overview
- Eligibility for people with a disability
- Parts A and B overview and costs
- Part D and Medicare Advantage costs
- Part D and Medicare Advantage enrollment
- Can a person with a disability who returns to work keep Medicare?
- Can someone with a disability get help to pay for Medicare?
- Summary
Some people with a disability do not need to wait until the age of 65 to become eligible for Medicare.
Those who have collected Social Security disability benefits for 24 months receive automatic enrollment into traditional Medicare, which comprises parts A and B.
There are three groups of people eligible for Medicare if they are under the age of 65. The time frame in which each group becomes eligible differs as follows:
Enrollment in Medicare parts A and B is usually automatic for someone in any of these three groups. As long as a person receives Social Security disability benefits, they will be eligible for Medicare.
Once a person with Social Security disability benefits meets the time frame requirement, they should receive their Medicare card in the mail. If they do not, they may wish to contact their local Social Security office.
If a person’s condition improves to the point that they no longer qualify for Social Security disability benefits, they will also no longer be eligible for Medicare coverage. Should this happen, they must wait until they reach the age of 65 before they can reenroll with Medicare.
We may use a few terms in this piece that can be helpful to understand when selecting the best insurance plan:
•Deductible: This is an annual amount that a person must spend out of pocket within a certain time period before an insurer starts to fund their treatments.
Traditional Medicare costs include those for Part A, which is for hospitalization insurance, and those for Part B, which is for preventive and medically necessary insurance.
Through Medicare, healthcare coverage for a person with a disability is identical to the coverage for an individual who qualifies because of their age.
The coverage from parts A and B does not include prescription drug costs. Coverage for prescribed medication is known as Medicare Part D.
A person may wish to include Part D as part of their plan, or they may decide to explore available options through Medicare Advantage.
Enrollment in one of these plans is possible, but it must be within a certain time frame.
The cost of premiums can vary depending on the extent or level of cover required and the person’s geographical location.
A person with a disability who wishes to enroll in either Medicare Part D or an Advantage plan may do so during:
•the 7-month period that begins 3 months before the 25th month of Social Security disability benefits
•the 7-month period that includes the 25th month of disability benefits
•the 7-month period that stops after the 25th month of disability benefits
Some people with a disability who are under the age of 65 are able to return to work. When this happens, they may keep their Medicare benefits for as long as they have a disability.
Once an individual goes back to work, they do not have to pay Part A premiums for the first 8 years and 6 months. After this time, however, they must pay the Part A premiums.
A person who cannot afford Medicare costs may be eligible for the Qualified Medicare Beneficiary (QMB) Program. This is one of the Medicare Savings Programs for people with low incomes. It helps pay the Part A and Part B premiums, along with any deductibles, coinsurances, and copayments.
To be eligible for QMB, a person cannot have a monthly income that exceeds $1,153. A married couple’s monthly income cannot exceed $1,546.
Medicare automatically enrolls people in parts A and B after they have been receiving Social Security disability benefits for 24 months.
The healthcare coverage for a person with a disability with parts A and B is identical to the coverage that people get when they enroll in the program at age 65.
If a person with a disability wishes to add prescription drug coverage, Part D, to their Medicare parts A and B, they may do so. They may instead opt to enroll in Medicare Advantage, which would take the place of Medicare parts A, B, and D.
Because a person must enroll in either Part D or Medicare Advantage within a specified time frame, they may wish to seek information on these programs in advance.
If you are under 65, you may be eligible to get Medicare earlier if you have a disability, End-Stage Renal Disease (ESRD), or ALS (Lou Gehrig’s Disease). Medicare is divided into four parts: Medicare Part A is insurance for hospitalization, home or skilled nursing, and hospice.
Jun 21, 2024 · You can qualify for Medicare if you have a disability and have been approved for Social Security Disability Insurance (SSDI). In most cases, you’ll need to wait 24 months before your Medicare...
Jan 18, 2018 · Qualifying for Medicare under 65 if you have a disability. If you’re under age 65 with a disability and receive disability benefits from the Social Security Administration (SSA) or the Railroad Retirement Board (RRB) for 24 straight months, then you will automatically be enrolled in Original Medicare, Part A and Part B.
Medicare is available for certain people with disabilities who are under age 65. These individuals must have received Social Security Disability benefits for 24 months or have End Stage Renal Disease (ESRD) or Amyotropic Lateral Sclerosis (ALS, also known as Lou Gehrig’s disease).
Jun 6, 2024 · A person can qualify for Medicare insurance when they are under age 65 years if one of the following applies: They are receiving Social Security disability benefits. They have ESRD. They have ALS.
