Do You Automatically Get Medicare With Social Security Disability?

Medicare coverage extends to those who are 65 years or older. However, it does not mean that those under the age of 65 years never qualify for Medicare coverage. The program also covers people suffering from disabilities and helps them meet their medical expenses. If you are under 65 years of age, you must be on Social Security Disability Insurance (SSDI) benefits to qualify for Medicare coverage.

An experienced and knowledgeable Socia Security Disability (SSD) benefits lawyer at London Eligibility can help you plan your medical expenses in advance by helping you understand the duration and coverage of the program.

Relationship between SSD benefits and qualifying for Medicare

It is a myth that you automatically qualify for Medicare after winning SSDI benefits. Merely winning Social Security Disability benefits will not qualify you for Medicare coverage by itself. To qualify for Medicare coverage, you will have to prove that you are suffering from a disability and that the Social Security Administration (SSA) has approved you for Social Security Disability Insurance (SSDI) benefits.

In most cases, there is a waiting period of 24 months receiving SSDI benefits before enrollment for Medicare.

The waiting period starts the first month of receiving SSD benefits check from the SSA. Once the 25th month of receiving SSDI benefits starts, you will get enrolled for Medicare coverage.

Exceptions to the 24 months norm

The general rule is that you must wait 24 months on SSDI benefits before enrollment on Medicare coverage. However, there are two important exceptions to this rule-

  • Amyotrophic Lateral Sclerosis (ALS).
  • Lou Gehrig’s Disease.

If you suffer from amyotrophic lateral sclerosis (ALS), or Lou Gehrig’s Disease, you will get Medicare coverage in the first month of receiving SSDI benefits.

Similarly, if you suffer from end stage renal disease (ESRD), your Medicare coverage begins after receiving dialysis treatment for three months.

What Is The Application Process For Medicare Coverage?

There is no prescribed application procedure for Medicare coverage. If you are suffering from a disability that prevents you from working, you may apply for Social Security Disability Insurance (SSDI) benefits. Therefore, your disability should meet the standards set by the Social Security Administration to qualify for SSD benefits.

Medicare does not concern your eligibility for SSDI benefits. Once the SSA approves you for disability benefits, there is nothing else left to be done on your part for Medicare coverage. Once the mandated waiting period of 24 months expires, you will get enrolled in Medicare coverage.

While you start receiving Medicare coverage from the 25th month of receiving SSDI benefits, you will receive the Medicare card at the end of the 22nd month of your SSDI benefits. Once you become eligible for Medicare coverage, you will get coverage from the program in Parts A and B, which is also called original Medicare.

  • 1). Medicare Part A: This Part extends to hospital care and such other short-term patient care facilities, including services at nursing homes. Generally, no premiums are to be paid for Part A Medicare coverage.
  • 2). Medicare Part B: Part B extends to different types of medical services that are not at the level of hospital care or nursing facilities, such as appointments with doctor and medical specialists, emergency room visits, ambulance facilities, access to medical equipment, preventive care, and some medicine supplies. Generally, a monthly premium is paid for Medicare coverage under Part B.

Can I Return To Work After Being Enrolled For Medicare Coverage?

Once you are approved for Medicare coverage, you will stay covered under the program, if a medical professional considers you disabled.

However, if you do return to work, the costs for your Medicare coverage will vary according to your age. If you are aged 65 or below and return to work, you will not have to pay any premium for Medicare Part A for the next 8.5 years.

On the other hand, if you are still under 65 years old after the 8.5-year period expires, you will have to start paying the monthly Part A premium. The standard monthly premium for Part A coverage depends on your work history. If you have fewer than 30 working quarters, that is, 7.5 years of coverage, you pay a monthly premium of $506/month. Finally, you pay a standard monthly premium of $278/month if you have 30-39 working quarters, that is, more than 7.5 years or less than 10 years.

Speak With An Accomplished SSD Benefits Lawyer At London Eligibility

If you or a loved one suffers from a disability, you must explore the possibility of getting Medicare coverage that would help you pay your outstanding medical bills. We understand how inflating medical bills can further aggravate your impairment(s). A knowledgeable SSDI benefits lawyer at London Eligibility can assist you in understanding the qualification criteria for coverage under the Medicare program. Contact us today for a free consultation and claim review.