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Medicare & Disability Waiting Periods: 3 Things You Should Know

Medicare will not be available to many of us until we are age 65, but for those with long term disabilities or those who have been diagnosed with specific diseases, Medicare is available much sooner. Here are 3 things you should know if you are waiting on disability and how it affects your Medicare benefits. 

If you’re able to establish that you suffer from a long-term disability that prevents you from working you may qualify for monthly SSDI (Social Security Disability Insurance) payments and for Medicare. However, even if you are approved to receive SSDI payments that don’t immediately qualify you for Medicare.

The waiting period for Medicare after you have been deemed unable to work is 24 months. 

A person receiving disability would be automatically enrolled in Medicare to start on the 25th month. (Social Security is who determines whether or not someone qualifies for SSDI checks, not Medicare)

Those living with a permanent disability are able to sign up for a Medicare Advantage Plan (Part C), a Prescription Drug Plan (Part D), or Medigap Plan A once they are enrolled in Medicare.

Here’s your time period breakdown: 

  • There is a 7 month window in which to enroll 
  • That time period starts 3 months prior to the 25th month
  • It end 3 months after.
  • Your coverage usually begins the first day of the month you join the plan.
  • If you join the plan in the 3 months before your 25th month your coverage will start on the first day of the 25th month.

There are a couple of exeptions: 

ALS

The exception to this rule when it comes to getting Medicare while disabled is if you have been diagnosed with Amyotrophic Lateral Sclerosis (ALS). In this case Medicare automatically begins the first month that your disability benefits starts. There is not a 24 month waiting period for those with ALS.  

ESRD

Another way you would become eligible for Medicare under age 65 is if you have End-Stage Renal Disease (ESRD or kidney failure). You may qualify if you have been diagnosed with ESRD and are undergoing dialysis treatments or have had a kidney transplant. When your Medicare benefits begin if you have ESRD depends on certain circumstances.

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