Some people can qualify for Medicare due to disability. In this case, if you have a qualifying disability, you are eligible for Medicare even if you are not yet age 65. To find out if your disability qualifies for disability benefits or for Medicare, you’ll need to speak with Social Security directly, but in general, you become eligible the 25th month of receiving Social Security Disability Insurance benefits (SSDI).
If you have a qualifying disability, you must first file for disability benefits through Social Security before you can even be considered eligible for Medicare due to disability. Approval of the request by Social Security is an important first step. It is also important to note that these benefits are different from Supplemental Security Income (SSI) benefits, and that SSI benefits do not qualify you for Medicare.
Enrolling in Medicare with a Disability
Just like when you become eligible for Medicare at age 65, when you are eligible with disability, you have an Initial Enrollment Period of 7 months.
Your Initial Enrollment Period will begin after you have received either disability benefits from Social Security for 24 months or certain disability benefits from the Rail Road Retirement Board for 24 months.1 In other words, your IEP starts on the 25th month of disability benefits.
You will be automatically enrolled in Medicare Part A and Part B, but if you decide you want to get a Medicare Advantage (Part C) or Part D prescription drug plan, you will need to enroll yourself directly with the private plan provider. You will need to enroll during your IEP to avoid late enrollment penalties.
NOTE: If you become eligible for Medicare because of ALS or ESRD, your situation is different. See the below special sections for eligibility and enrollment for ALS and ESRD.
Do I have to take Part B?
You are not required to take Part B, and some people choose to delay. Deciding to opt out of Part B at this time is a personal choice and depends on your unique situation. Click here to read more about whether or not you should take Part B when you qualify for Medicare with a disability. Some people who qualify for Medicare under age 65 due to disability but are covered under an employer’s plan or a spouse’s employer plan, may opt to delay.2
If You Get Medicare for Disability and Then Return to Work
If you get Medicare due to disability and then decide to go back to work, you can keep your Medicare coverage for as long as you’re medically disabled.3 And, if you do go back to work, you won’t have to pay the Part A premium for the first 8.5 years.
Part A is premium-free for those with a disability and under 65 only if you get Social Security or Railroad Retirement Board benefits for 24 months or have ESRD and meet certain requirements.4
If you’re 65 or older, Part A is premium-free if you or your spouse worked and paid Medicare taxes for at least 10 years, you already get retirement benefits from Social Security or the Railroad Retirement Board, or you’re eligible for these benefits but haven’t filed for them yet.5