Do you automatically get Medicare with a disability?

If you are under the age of 65 and have a disability, specifically if you are receiving Social Security disability benefits, you are eligible and can enroll in Medicare, a health insurance program for people older than 65. The coverage does not change based on eligibility. It is the same for those who qualify based on age as it is for disabled individuals 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 benefits.

If you have Amyotrophic Lateral Sclerosis (ALS or 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 on 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 End-Stage Renal Disease, you can become eligible three months after a regular dialysis course starts, or after a kidney transplant.
  • For Amyotrophic Lateral Sclerosis, 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 health coverage. However, specific criteria will need to be met to be eligible to receive specific health care services and care, but the status of your health should not be used as a reason to deny you health care 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 417-6313-7200.

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