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powered by health insurance experts.

Q: Disability and Medicare: Can I Get Medicare Before 65 If I’m Disabled?

Asked by Jeffrey on November 8, 2017

Hal Levy November 8, 2017

We’ve answered a similar question on disability and Medicare previously. 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 enroll in Medicare. You can only join Medicare due to a disability if you receive payments from the Social Security Disability Insurance (SSDI) program. SSDI has its own requirements for acceptance.

You can enroll in Medicare before the age of 65 if:

  1. If you receive SSDI payments (which you must have received for 24 months);
  2. If you were diagnosed with ALS (you can enroll immediately once you receive your first SSDI payment; OR
  3. 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 automatically you eligible for Medicare before 65:

  1. If you deal with any other kind of serious health problem;
  2. If you receive worker’s compensation; OR
  3. If you have a diagnosis for another disability not included in the previous section.

To qualify for disability and Medicare coverage, you or your spouse must also receive Social Security benefits, or have paid Social Security taxes for about 10 years (or the equivalent Railroad Retirement Board or government employee benefit – the rules have changed several times over the past few decades).

Medicare Disability Enrollments Are Common: Medicare is generally thought of as health insurance for those over the age of 65, but 16 percent of Medicare beneficiaries enrolled earlier due to a disability.

Medicare Differences on Disability: Your Original Medicare (Parts A & B) benefits will be the same as if you had aged into Medicare. However, it will be more difficult for younger enrollees to get private supplementary coverage until they turn 65.

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 comprehensive and free, is a much easier way to get healthcare if you’re disabled or out of work. While you generally have to renew Medicaid coverage each year, you can enroll very quickly. If you receive Supplemental Security Income (SSI) or have limited income, you may also qualify for Medicaid.

Taking the Next Steps

Learn more about Medicare coverage at Some Medicare Supplement plans may also provide coverage for those under 65 and dealing with a disability.

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