If you get social security disability do you get medicare

Medicare coverage kicks in for most SSDI recipients two years after the first month they are eligible for their monthly disability benefits. However, this doesn’t automatically mean that every person approved for SSDI must wait two years to get their Medicare coverage. The two-year Medicare waiting period generally gets calculated from the date of your SSDI entitlement (the date you are eligible to receive your monthly award). Normally, this is the date your disability began plus the five-month SSDI waiting period.

However, things get a little tricky depending on your disability onset date.  Depending on how far back you became disabled, you may have met a good portion of the waiting period by the time you are approved for benefits. But, because Social Security only allows a maximum of 12 months of retroactive benefits, plus the 5-month waiting period for benefits, the earliest that you can become eligible for Medicare is one year after you apply for Social Security disability.

For instance, let’s pretend you became disabled in July 2016. Since there is a five-month waiting period, your Social Security Date of Entitlement would be in December of 2016. You didn’t apply for Social Security benefits as soon as you became disabled, so your application date was January 2017. You had to go through the appeals process as you were initially denied, but you were finally approved for benefits in September 2018 with an entitlement date of December 2016. Since it has been two years since your Date of Entitlement, you will start receiving Medicare benefits in December 2018.

But, if you recently become disabled and were approved with an entitlement date of August 2018, you would not become eligible to receive Medicare benefits until August 2020. There are exceptions to this rule if your disabling diagnosis is End Stage Renal Disease or Amyotrophic lateral sclerosis (ALS). People with these conditions receive expedited Medicare coverage.

In most states, if you are approved for SSI, you will receive benefits automatically through Medicaid as SSI’s income and asset limits mirror that of Medicaid’s. However, there are a few states that still require you to complete a separate application process for Medicaid benefits because those states choose to make their own Medicaid determinations. For SSI recipients, there is no waiting period to receive Medicaid. Generally, people on SSI can still get Medicare benefits as well, but only when they turn age 65. At that point, they can file an “uninsured” Medicare claim, which means the state they live in pays the medical premium for Medicare.

Summary:

It typically takes two years to receive Medicare benefits if you are under 65 and receiving Social Security disability benefits. However, certain health conditions such as Lou Gehrig’s disease and end-stage renal disease (ESRD) make you exempt from this waiting period.

You will typically be automatically enrolled in Original Medicare, Part A and B, after you’ve received Social Security disability benefits (or certain Railroad Retirement Board disability benefits) for two straight years. Your Medicare coverage will start 24 months from the month you qualified for disability benefits. In some cases, this could be earlier than the month when you received your first check. You must be either a U.S. citizen or legal permanent resident of at least five continuous years to be eligible for Medicare.

Note that certain conditions may qualify you for Medicare under age 65, but have different enrollment details than those described above.

• If you have Lou Gehrig’s disease (Amyotrophic Lateral Sclerosis, or ALS), you’re enrolled in Medicare automatically the first month you receive disability benefits from Social Security or the Railroad Retirement Board. The life expectancy of someone with ALS averages two to five years from the time of diagnosis, according the ALS Association. If you have ALS, you may not have time to wait two years on Social Security disability.
• If you have end-stage renal disease (ESRD), you might qualify for Medicare, but you’re not automatically enrolled. End-stage renal disease means kidneys are functioning at 10 to 15 percent of their normal capacity according to the Cleveland Clinic. At that point, the choices are dialysis or a kidney transplant. If you’re on dialysis or you’ve had a kidney transplant, contact Social Security (information below).

You can get more information about Medicare and Social Security disability benefits from the Social Security Administration:

• On the Social Security website.
• Over the phone, at 1-800-772-1213 (TTY users can call 1-800-325-0778) from 7AM to 7PM Monday-Friday.
• In person by visiting a local Social Security office.

People who qualify for Medicare may be dual eligible for Medicaid. There may be no waiting period for Medicaid coverage.

To find a Medicare plan that covers people with disabilities, enter your zip code on this page.

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