Can I Get Medicare If I Have a Disability?
If you’re younger than 65, you may qualify for Medicare if:
- You have received Social Security disability benefits or certain Railroad Retirement Board disability benefits for a minimum of 24 months
- You have End Stage Renal Disease (ESRD)
- You have Amyotrophic Lateral Sclerosis (ALS), otherwise known as Lou Gehrig’s Disease
If you have ESRD, you do not have to receive Social Security Disability benefits for 24 months before becoming eligible. Instead, you can generally obtain Medicare coverage three months after beginning a regular course of dialysis, or after you’ve received a kidney transplant.
Those with ALS are eligible as soon as their Social Security Disability benefits begin.
Enrolling in Medicare
Those receiving disability benefits for 24 months or those who have ALS will be automatically enrolled in Medicare Part A and Part B. Your Medicare card will arrive in the mail three months before your 25th month of disability.
If you have ALS, there is no waiting period.
ESRD patients must manually sign up. To do so:
- Apply online at Social Security.
- Visit your local Social Security office.
- Call Social Security at 1-800-772-1213 (TTY: 1-800-325-0778).
- If you worked for a railroad, call the RRB at 1-877-772-5772.
- Complete an Application for Enrollment in Part B (CMS-40B). Get this form and instructions in Spanish. Remember, you must already have Part A to apply for Part B.
Additionally, if you qualify for Social Security Disability benefits, you should receive your Medicare card by mail as soon as the minimum time has passed.
Medicare Part A and Part B Coverage
If you obtain health insurance coverage through Medicare, you’ll benefit from the same type of coverage that millions of American seniors enjoy. This includes Medicare Part A (hospital insurance) and Medicare Part B (medical insurance).
Medicare Part A generally covers:
- Hospital care
- Home health services
- Skilled nursing facility care
Medicare Part B generally covers:
- Medically necessary services, like doctor’s visits, surgeries, lab tests, clinical research, ambulance services, mental health (inpatient and outpatient) and durable medical equipment
- Preventive services to prevent illness or to detect an illness at an early stage
Though both parts of Original Medicare offer a wide range of health insurance coverage, they each leave some out-of-pocket costs to you as a beneficiary. These costs can include deductibles, copayments, coinsurance and other fees, and they can add up quickly.
Medicare Supplement Insurance Helps Cover Costs
One way that millions of Medicare beneficiaries get help paying for some of these health care costs is by purchasing a Medicare Supplement Insurance plan (also known as Medigap).
The 10 standardized Medicare Supplement Insurance plans offered in most states each cover a different combination of health insurance costs.
If you are enrolled in Medicare because of a disability and are younger than age 65, you may be able to purchase Medigap insurance in your state. However, not all states require insurers to sell Medigap plans to people under 65.
It’s important to find out if health insurance companies in your state offer Medigap plans to those with disabilities.