Enrolling due to a disability

Medicare Benefits Solutions
May 4, 2020

Millions of Americans receive Medicare benefits under the age of 65 due to disability. If you’ve been receiving disability benefits through Social Security or the Railroad Retirement Board (RRB), or have been diagnosed with certain illnesses, you may be eligible for Medicare.

When can you get Medicare?

You may qualify for Medicare if you’ve been getting disability benefits from Social Security for 24 months or if you have been getting certain disability benefits from the RRB for 24 months. If this is the case, you’ll automatically be enrolled in Medicare in your 25^th month of disability. You’ll even get your Medicare identification card in the mail three months before your 25^th month of disability.

If you’re diagnosed with ALS, also known as Amyotrophic Lateral Sclerosis or Lou Gehrig’s disease, you will automatically get Medicare Part A and Part B the month your disability benefits begin.

If you’re diagnosed with ESRD (end-stage renal disease), your kidneys no longer work, and you need regular dialysis, you’ll qualify for Medicare as long as you’ve worked the required amount of time under Social Security, the RRB, or for the government. You may also qualify if you’re already getting Social Security or RRB benefits, or if you’re the spouse or dependent child of a person who meets those requirements.

Medicare Advantage Plans

If you’ve been getting disability benefits from Social Security or the Railroad Retirement Board, you will have a 7-month Initial Enrollment Period when you can sign up for a Medicare Advantage plan. This period begins three months before your 25^th month of disability and ends three months after your 25^th month.

Some insurance companies offer Medicare Advantage Special Needs Plans (SNPs) that cater their coverage to specific chronic illnesses or circumstances. Some Special Needs Plans limit their membership to individuals who live in a skilled nursing facility or to people who are dual-eligible for both Medicare and Medicaid.

Compare the options offered in your area to find the plan that will suit your needs. Review the plans offered in your area, but don’t hesitate to ask for help if you have questions along the way. Licensed, knowledgeable sales agents are available to help you navigate your options and enroll.