Not Yet 65 , Can I Qualify for Medicare by Disability?

Wed, Apr 7, 2021 10:42 PM Medicare Medicare Part D

You could be eligible for Medicare to cover your medical costs if you apply for Social Security disability benefits, this is a monthly payment to help offset missed income due to a permanent disability.

Many people must have been receiving Social Security disability benefits for at least two years to be eligible for Medicare, but this two-year waiting period does not extend to all.

To be eligible for Social Security disability and Medicare coverage, you must meet certain criteria.

If you've been diagnosed with an illness that has rendered you permanently disabled — meaning you won't be able to function for at least a year — you can apply for Social Security disability benefits at ssa.gov. To be qualified, you would have served in a Social Security-qualifying job and paid Social Security taxes.

Furthermore, your medical condition must prohibit you from performing your regular job functions, and you must have been unable to find a suitable substitute job or new line of work due to your age, schooling, or physical limitations. You will lose your Social Security disability benefits if you do not continue to pursue your doctor's approved care plan to improve your condition.

To be eligible for Medicare, you must have received Social Security disability insurance for at least 24 months. Some people can decide to sign up right away. Based on different impairment situations, here's when and how to enroll.

 

Kidney failure that has progressed to the end-stage (ESRD)

You must manually enroll in all aspects of Medicare if you have ESRD (also known as kidney failure). And if you have ESRD, you will be eligible to participate in a Medicare Advantage plan starting January 1, 2021.

• You must sign up for Medicare Advantage during one of the open enrollment periods.

• You must be enrolled in Medicare Parts A and B and live in the plan's coverage area.

 

You've been diagnosed with Lou Gehrig's disease

If you have amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig's disease, you will be eligible in Medicare Part A (hospital insurance) the first month you receive Social Security disability benefits. If you live in one of the 50 United States or the District of Columbia, you will be automatically enrolled in Medicare Part B (medical insurance). If you already have medical insurance, you will have the opportunity to decline the automatic enrollment in Medicare Part B. If you need prescription drug coverage, you must enroll separately in a Medicare Part D prescription drug plan.

 

You live in the District of Columbia and outside the 50 United States

If you don't live in one of the 50 states or Washington, D.C., but do live in a US territory like Puerto Rico, your automatic enrollment would be limited to Medicare Part A. (hospital insurance). Otherwise, you'll have to enroll yourself when you're ready. Medicare Part B and a Medicare prescription drug plan must still be enrolled separately.

 

Receiving Social Security disability benefits for the past 24 months

At the start of the 25th month after receiving your Social Security disability insurance, you will be automatically enrolled in Medicare Parts A and B (Original Medicare). Many that do not reside in one of the 50 United States or the District of Columbia, or who have the end-stage renal disease (ESRD), are exempted.

If you want a prescription drug plan, you can apply individually for a Medicare prescription drug plan (Medicare Part D) through a private insurance carrier. Enroll in a Medicare prescription drug plan as soon as three months before the Social Security disability payments' 25th month.

You can use the Medicare Services plan comparison tool on this page to participate in a Medicare Prescription Drug Plan.

 

Original Medicare (Parts A and B) is available via Social Security:

 

• By phone at 1-800-772-1213 (TTY users 1-800-325-0778), Monday through Friday, from 8 AM to 7 PM in all U.S. time zones.

• Online at ssa.gov.

• In-person at your local Social Security office.

 

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