Medicare with a disability

Do you automatically get Medicare with a disability?

If you are under the age of 65 and have a disability, you can enroll in Medicare. The coverage does not change based on eligibility. It is the same for those who qualify based on age as it is for those who qualify based on disability. 

When enrolling in Medicare, you are guaranteed to have certain rights and protections that are required to:

  • Provide protection and coverage when receiving health care
  • Provide protection against unethical practices
  • Provide protection for your privacy
  • And, ensure that you receive the health services the law says you can receive

Receiving disability benefits 

If you receive disability benefits from Social Security or the Railroad Retirement Board (RRB) for 24 months, you will receive Medicare Part A and Part B, and receive your Medicare card three months before your 25th month of disability. 

If you have Amyotrophic Lateral Sclerosis (ALS), also referred to as Lou Gehrig’s Disease, you will be enrolled in coverage the first month you receive Social Security Disability Insurance. If you have End-Stage Renal Disease (ESRD), your Medicare coverage will begin the first day of the fourth month of your dialysis treatment. 

To be eligible for Medicare if you have ESRD or ALS, you need to meet specific requirements:

  • For ESRD, you can become eligible three months after a regular dialysis course starts, or after a kidney transplant.
  • For ALS, your eligibility begins immediately after receiving Social Security benefits.

Under 65 years old with a disability 

If you are under 65 years old with a disability and plan to return to work, you can keep your Medicare coverage as long as you are medically disabled. After returning to work, you will not have to pay your Part A premium for the first 8.5 years you are back to work. After those 8.5 years, you will pay the Part A premium. 

Note that your Medicare costs will depend on your specific circumstances. Each Medicare part has its own rules and costs to explore.

Can I be denied coverage?

No illness or underlying condition will cause you to be denied coverage. However, specific criteria will need to be met to be eligible to receive specific services and care, but the status of your health should not be used as a reason to deny you coverage with Medicare.

If you feel you have been wrongly denied coverage or discriminated against, you can file a complaint through the Department of Health and Human Services.For any Medicare eligibility questions, give Temmen Insurance a call at 417-633-7200.

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