Medicare and Disability

If you are disabled and under the age of 65, you may be eligible for Medicare if certain criteria are met. If your situation qualifies you for Medicare, the full range of benefits will be available to you. This includes hospital care, home health, possibly nursing home care, physician visits, community-based services, and prescription drug coverage.

Under Age 65 With a Disability

Under age 65 and receiving SSDI. If you have received Social Security disability insurance (SSDI) from the Social Security Administration, 24 months after your first compensation payment, you will automatically be enrolled in Medicare Part A and Part B.  Part A covers you when you are in the hospital and Part B covers your other medical expenses.

You may also delay receiving Medicare Part B if you believe you already have adequate healthcare coverage for out-of-hospital care outside of Medicare. Perhaps you are still working and are covered under your employee benefit plan or under your spouse’s plan if you are not still working.

If you are covered under a military health plan, such as TRICARE, or are receiving Veteran’s Benefits, you may decide Part B is not for you. You should consult with a qualified representative before making any decision about Part B coverage. Some plans, such as CHAMPVA require you to have Part B Medicare coverage in order to keep your CHAMPVA coverage in place. In other situations, if you drop or refuse Medicare Part B, you may later be charged a penalty when you decide you need that part of Medicare.

You may choose Medicare Part C (a Medical Advantage Plan), or Part D (Medicare prescription drug coverage.)

Under age 65 and receiving RRB. You may also qualify for Medicare under the age of 65 if you have received certain disability benefits from the Railroad Board (RRB) for 24 months.

Going back to work. If you decide to go back to work, you can still keep your Medicare coverage for as long as you are medically disabled. There are income limits that may apply.

No disqualifying medical conditions. There are no disqualifying medical conditions that prevent a person from receiving Medicare under the age of 65. A person can be disabled due to Alzheimer’s disease, mental illness, multiple sclerosis, Parkinson’s disease, or any other chronic disabling condition. The condition may be one where you are not expected to improve and that will require long-term care. The only requirement is that you have been receiving SSDI for 24 months.

People Diagnosed with Lou Gehrig’s Disease (ALS)

No matter how old you are, if you have been diagnosed with Amyotropic Lateral Sclerosis (ALS), known also as Lou Gehrig’s disease, you are eligible for Medicare as soon as you begin collecting SSDI. There is no waiting period.

People Diagnosed with End Stage Renal Disease (ESRD)

Regardless of your age, if you have been diagnosed with ESRD, you are generally eligible for Medicare three months after you have begun a course of regular dialysis, or after you have had a kidney transplant. The 24-month waiting period that applies to those receiving SSDI does not apply to those with ESRD.

How We Can Help

Each situation is unique. Deciding which Medicare Plan will best suit your needs is not easy. We can help you with that decision by analyzing your situation and discussing with you your options. We want to help you get the coverage that fits you the best. Contact us to discuss how we can help you compare plans and benefits.

source:

medicare.gov

medicareadvocacy.org/medicare-info/medicare-coverage-for-people-with-disabilities