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Qualifiy for Medicare with a Disability

Medicare is available for certain people with a disability who are under 65. To qualify, you must have received Social Security Benefits for 24 months, or have End-Stage Renal Disease or Lou Gehrig’s Disease.

End-Stage Renal Disease

If you have ESRD, you can sign up for Medicare before 65 if you need regular dialysis, or have had a kidney transplant, and meet one of the following:

Worked the required amount of time under Social Security or Railroad Retirement Board.

Eligible to receive or already receiving Social Security or Railroad Retirement Benefits.

Spouse or dependent child of a person who meets the requirements listed above.

Eligible for Medicare because of ESRD, enrollment is not automatic and you will need to enroll in Medicare by contacting your local Social Security office. Benefits typically start on the first day of the fourth month of your dialysis treatments. If you are covered by an employer health plan, your coverage will still start the fourth month of dialysis treatments. Your group may pay for the first 3 months of dialysis. If you participate in a Medicare-certified training program to learn how to administer dialysis treatments from home and are expected to do so, treatments continue through the waiting period. Medicare will end 12 months after you stop dialysis or 36 months after you have a kidney transplant. Coverage can be extended if you start dialysis or get a transplant within 12 months of stopping treatment, or 36 months after the transplant.

Enrollment

Even if you are under 65, enrollment with a disability is automatic. After receiving Social Security benefits or Railroad benefits for 24 months, you will receive your Medicare card in the mail. Look for the card to arrive three months before your 25th month of disability. If you have Lou Gehrig’s Disease, enrollment is automatic, but benefits are available after your first month of disability. You can opt out of Part B coverage if you choose. Instructions on the back of the card explain the process. If you choose not to accept Part B before age 65, you will automatically be enrolled again when you turn 65.

 

 

 

 

 

 

 

 

 

References:

Medicare with a disability: https://www.medicare.gov/people-like-me/disability/signing-up-for-part-b-disability.html

Medicare with ESRD: https://www.medicare.gov/people-like-me/esrd/getting-medicare-with-esrd.html#collapse-3178

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