Available Mon-Fri, 9am-6pm ET  |  Call 800-970-1964

Medicare for the Disabled

Many people are surprised to learn that Medicare isn’t just for people age 65 and older. Millions of Americans can get Medicare under age 65 based on their disability status. The benefits they get from Medicare will be identical to everyone else, but there are certain unique rules and time frames apply when receiving Medicare under age 65.

When Does Medicare Start for those with SSDI

For most people it will start in the 25th month after your SSDI payment begins. 

Typically, they receive Medicare Part A immediately and Medicare Part B will become effective 24 months after Part A.

The two year wait seems cruel, but that was a compromise Congress made to get a benefit approved for those under age 65.

Disabilities That Qualify for Medicare Under 65

All disabilities will qualify you for Medicare under age 65, but you’ll have to wait 24 months after getting SSDI in order for your Medicare Part B coverage to begin.

Disabilities that are eligible for IMMEDIATE Medicare benefits

  • End Stage Renal Disease (ESRD), also known as Kidney Failure
  • ALS, also known as Lou Gherig’s Disease

What Happens at Age 65

You’ll be eligible to enroll in Medicare “again” as described above. What won’t happen (and what most people are hoping will happen) is an increase in your monthly Social Security payments. 

Age 65 is not the magic age for Social Security. Your Full Retirement Age is between age 66 – 67, and is no longer age 65. At your FRA you will automatically transition from SSDI to SS Retirement. It happens behind the scenes, you don’t need to do anything and sadly, you won’t be getting a monthly increase. 

The monthly SSDI payment you receive will continue for the rest of your life, with only a small cost of living increase each January. At your FRA, you can start working and earn as much money as you want without your Social Security being reduced! You also will no longer have a medical review of your disability.

Medicare Supplements for Under 65

In most parts of the country, Medicare Supplements are either not offered at all to those under 65 or they are hundreds of dollars per month more expensive than a typical 65 year old would have to pay for the same Medicare Supplement plan.

Certain states require insurers to charge the same amount for a Medicare Supplement regardless of whether the applicant is under 65 or not.

The good news is, that if you are unable to get / afford a Medicare Supplement at first, you will get another open enrollment period at age 65.

IMPORTANT: Disabled Medicare beneficiaries get a second Initial Enrollment Period when they turn age 65. This is often their only opportunity to get a Medicare Supplement without health questions. 

Medicare Advantage for Under 65

Medicare beneficiaries are able to enroll in a Medicare Advantage plan regardless of their age. There are no states that prohibit enrollment into Medicare Advantage plans based on age, unlike Medicare Supplements.

FAQs

Yes and no. If you’ve been on SSDI for 2 years and didn’t sign up for Medicare within 7 months of becoming eligible, you are now “late.” You can only sign up during the General Election Period and you will pay a late penalty for every year that you were late (10% per year).

 

The good news is that when you do turn 65 any penalties you have will go away!

 

Call us at 800-970-1964 and we can help you get into Medicare at the next available opportunity.

No. Your Medicare Part B premium is based on your income. You may qualify for Medicaid and get assistance paying for Medicare Part B, or you may have to pay more for Part B than the average American. Part B is based on your income from 2 years prior and will count your joint income if you are married.

No, in most states you will not be able to get one and in some of the few states that do allow it your monthly premium will be double someone age 65. Medicare insurance rules vary by state and can vary widely!

 

Most states only have Medicare Advantage plans available for those under age 65 on Medicare due to disability. MAPD is a great option but once you turn 65, you have other options too. At age 65 you are able to get a Medicare Supplement Plan just like everyone else that is entering Medicare for the first time. You won’t be charged more due to your disability and every company has to accept you that sells plans in your state.

Great news! You can keep Medicare for 93 months as long as your disabling condition continues. This is a generous way SSDI encourages people to go back to work, and keep their health care benefits.

Summary

Recipients of SSDI are able to get Medicare before turning age 65. Most will have to wait 24 months after qualifying for Social Security Disability before they receive Medicare Part B. If you are on SSDI, contact us 3 months before your Medicare Part B starts to compare plans available in your area.

Our Service Never Costs You A Dime!