If you’re “on disability,” then you may be able to get Medicare before you turn 65.
That said, not every type of disability lets you get Medicare coverage. You can only join Medicare due to a disability if you receive payments from the Social Security Disability Insurance (SSDI) program for 24 months. SSDI has its own requirements for acceptance.
You can qualify for Medicare before the age of 65 if:
- If you receive SSDI payments (which you must have received for 24 months);
- If you were diagnosed with ALS (you can enroll immediately once you receive your first SSDI payment); OR
- If you were diagnosed with end-stage renal disease or ESRD. (Your enrollment depends on the type of treatment you receive).
Things that won’t make you automatically eligible for Medicare before 65:
- If you deal with any other kind of serious health problem;
- If you receive worker’s compensation; OR
- If you have a diagnosis for another disability not included in the previous section.
You must have worked long enough and earned enough Social Security work credits to qualify for disability benefits. The number of work credits you need depends on your age when you become disabled. Generally, you need 40 credits, 20 of which were earned in the last ten years ending with the year you become disabled.1 Younger workers may qualify with fewer credits.
Medicare Disability Enrollments Are Common: Medicare is generally thought of as health insurance for those over the age of 65, but about 12% of Medicare beneficiaries enrolled earlier due to a disability.
Medicare Differences on Disability: Your Original Medicare (Part A & Part B) benefits will be the same as if you had aged into Medicare. However, in some states, it will be more difficult for younger enrollees to get private supplementary coverage until they turn 65. Several states do require supplement insurers to offer plans to SSDI beneficiaries (although the premiums could be higher.) Also, such individuals can enroll in a Medicare Advantage plan.
Medicare beneficiaries who are eligible due to disability can generally get Part D prescription drug plans. Each state has different rules about whether and how Medicare Supplement plans should serve disabled enrollees. You could also lose Medicare coverage if you’re no longer disabled.
Medicare Alternatives: Medicaid, which is a free or low cost program managed by individual states, is an alternative way to get healthcare if you’re disabled. If you receive Supplemental Security Income (SSI) or have limited income, you may also qualify for Medicaid. Also, you will generally have to renew Medicaid coverage each year.
Taking the Next Steps
Learn more about Medicare coverage at Healthcare.com/medicare
1. Social Security Administration. “Benefits Planner: Disability | How You Qualify.” ssa.gov (accessed March 4, 2020).
2. Kaiser Family Foundation. “Distribution of Medicare Beneficiaries by Eligibility Category.” kff.org (accessed March 2020).