Medicare for People under 65 with Disabilities

Medicare Rights Center

People under 65 with disabilities may have to play a waiting game, but they will get Medicare coverage eventually. There are several “musts.” In order to get Medicare coverage, the person who has been declared to have a disability must have been receiving Social Security Disability Insurance (SSDI) for 24 months. Of course, in order to get SSDI, you must have paid Social Security taxes. The average SSDI payment in 2018 is $1,197 per month.

Once you have received SSDI for the 24-month period, you will automatically be signed up for Medicare Part A and Part B. You will not pay a premium for Part A, but, like any Medicare beneficiary, you will pay a premium for Part B. You will need to get separate prescription drug coverage, Part D, either through Medicare or by purchasing a Medicare Advantage plan.

Exceptions to the 24-month waiting period

If you have ALS (Lou Gehrig’s disease), there is no waiting period to get Medicare coverage. You will be covered as soon as your disability payments begin. If you have ESRD (End Stage Renal Disease), coverage will begin three months after a course in dialysis or a kidney transplant.

Eligibility issues

Basically, you are eligible for disability insurance if you are unable to earn more than $1,180 a month if you are ill, injured or disabled or $1,970 if you are blind and this is expected to continue for a year. Medicare will kick in after 24 months of SSDI.

If you are able to return to work and you lose the SSDI, you may continue to receive coverage for eight and a half years. After that, you must pay for Part A. You also must take your employer’s health coverage, if offered.

If you meet the standards for having a disability but do not qualify for Social Security, you will be able to purchase Part A and pay a monthly premium in addition to your Part B premium.

The Medicare coverage you receive as a disabled person under 65 is the same coverage available to people who receive Medicare at the age of 65 and over. In fact, if you are receiving Medicare disability coverage and turn 65, your plan will automatically transform into age-related coverage.

Visit medicare.gov to find out more, including how to sign up. Also, check out our YouTube videos and blog page for more information!

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