When most people think of Medicare, they associate it with individuals turning 65. However, many are unaware that Medicare also provides coverage for individuals under 65 who are living with disabilities. If you or someone you know is under 65 and navigating disability benefits, understanding Medicare eligibility can open the door to essential healthcare coverage.
Individuals under 65 can qualify for Medicare coverage if they meet specific disability-related criteria set by the Social Security Administration (SSA):
If you receive SSDI benefits for at least 24 months, you automatically become eligible for Medicare.
The 24-month waiting period begins the same month you start receiving SSDI benefits.
Amyotrophic Lateral Sclerosis (ALS): Individuals with ALS (also called Lou Gehrig’s disease) automatically qualify for Medicare coverage as soon as they start receiving SSDI benefits. There is no waiting period.
End-Stage Renal Disease (ESRD): Individuals with kidney failure who require regular dialysis or a kidney transplant are eligible for Medicare. Coverage usually begins after:
The third month of dialysis treatment, or
The first month of dialysis if certain training conditions are met.
Once eligible, individuals under 65 with disabilities receive the same Medicare benefits as those over 65:
Medicare Part A (Hospital Insurance): Covers inpatient hospital stays, skilled nursing facility care, hospice care, and limited home health services.
Medicare Part B (Medical Insurance): Covers doctor visits, outpatient care, preventive services, and durable medical equipment.
You also have the option to enroll in additional plans, such as:
Medicare Advantage (Part C): Combines Part A, Part B, and often Part D (prescription drug coverage) into a single plan.
Medicare Part D: Helps cover the cost of prescription medications.
Medicare Supplement Plans (Medigap): Helps pay for out-of-pocket costs like copayments, coinsurance, and deductibles.
At the Senior Services Insurance Agency, we specialize in helping seniors and individuals with disabilities choose plans that meet their needs and budget.
Navigating Medicare eligibility and enrollment can be confusing, especially if you are under 65 and dealing with health challenges. Our team has been guiding individuals through the complexities of Medicare since 2008, ensuring you get the coverage you need without the stress.
Here are some reasons why consulting with our team can make a difference:
Expert Guidance: We simplify Medicare and help you understand which parts of Medicare you need.
Access to Plans: From Medicare Advantage to Part D prescription drug plans, we help you find affordable coverage that works for you.
Peace of Mind: Knowing your healthcare costs are covered allows you to focus on your well-being and enjoy retirement.
If you’re under 65 and eligible for Medicare due to disability:
Wait for Automatic Enrollment: After receiving SSDI benefits for 24 months, you’re automatically enrolled in Medicare Parts A and B.
Choose Additional Coverage: Consider adding Medicare Advantage, Part D, or a Medigap plan to enhance your benefits.
Get Professional Help: Contact our team at Senior Services Insurance Agency to compare plans, understand costs, and ensure you’re making the best choice.
Medicare isn’t just for seniors; it’s a critical healthcare solution for individuals under 65 living with disabilities. By understanding the eligibility criteria and coverage options, you can access the care you need to improve your quality of life.
At the Senior Services Insurance Agency, we’re dedicated to helping you navigate Medicare with confidence. Whether you need Medicare Advantage, Part D prescription drug plans, or final expense insurance, we are here to guide you every step of the way.
Let us simplify Medicare so you can focus on enjoying life—one step at a time.
