Medicare is Not Just for Retirees: Disabled Individuals May Qualify

The Medicare health insurance program covers Americans above the age of 65. However, other groups might be eligible for this coverage as well, including those with disabilities.

Who is eligible for Medicare coverage?

For Medicare eligibility as a senior citizen above the age of 65 you: 

• must be a citizen or permanent legal resident of the United States;
• or your spouse must be eligible or must receive Social Security benefits or railroad retirement benefits;
• or your spouse must have been government employees for long enough in a job in which Medicare taxes were paid; or
• must be the dependent parent of an insured, deceased child.

However, persons below the age of 65 can qualify for Medicare coverage under certain circumstances. 

Apart from persons above the age of 65, Medicare coverage can include persons: 

• with disabilities;
• who suffer from permanent kidney failure or end-stage renal disease; and
• who have suffered amyotrophic  lateral sclerosis, more commonly known as Lou Gehrig’s disease.

Those who qualify because they have a disability must be entitled to Social Security disability benefits for at least 24 months. Medicare may not be available for the first two years of disability benefits. However, note that the 24 months do not have to be consecutive.

So you may receive Social Security disability benefits for nine months, then go two months without benefits, and then receive benefits for another 15 months and qualify for Medicare as a disabled recipient. However, if you have kidney failure or end-stage renal disease, or if you have Lou Gehrig’s disease, you may qualify sooner.

Also note that if you receive Supplemental Security Income (SSI) – a needs-based program – you may receive Medicaid. But you may also qualify for Medicare, in which case you would qualify for Extra Help with Medicare Prescription Drug Coverage.

What type of Medicare may persons under 65 receive?

A person who is eligible for the Medicare program – whether over 65 or younger than 65 – is automatically eligible for benefits under Medicare Part A, the hospital insurance program. Those who wish may purchase Medicare Part B, the medical insurance program.

The Part B program is optional. When you become eligible for Part A of the program, you will get a time period of seven months in which you must sign up for Part B medical insurance; this is called your initial enrollment period. Delays in signing up will result in delays in coverage, and may result in higher premiums.

For those 65 and older, the initial enrollment period starts three months before you turn 65. But if you are applying for Medicare based on disability or end-stage renal failure, your initial enrollment period begins on the date that your kidney failure or disability began.

Legal Help for Disabled Patients Seeking Social Security Disability

If you are currently experiencing delays or trouble recovering Social Security disability benefits, or other disability benefits such as Medicare coverage, speak with a lawyer at Rob Levine & Associates. Call 866-LAW-SSDI (529-7734) to schedule a free case evaluation with an attorney.