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How Does Social Security Disability Insurance (SSDI) Work with Medicare?

If you have a disability, you might need Medicare before you turn 65. If you are eligible for Social Security Disability Insurance benefits, extra coverage might be essential. Thankfully, you are able to receive the coverage you need through Medicare.

What Qualifies You for Medicare Disability Benefits?

If you are permanently disabled, this means you have a medical condition that prevents you from working. You qualify for Social Security Disability Insurance if you cannot work for 12 months or longer. It is easy to apply for Social Security Disability. As long as you paid Social Security taxes while you were working, you can apply through the Social Security website.

Once you receive Social Security Disability benefits, you are able to receive Medicare coverage. If you are under 65, you are automatically enrolled in Medicare Part A and Medicare Part B. This happens after you have had disability benefits from Social Security for 24 months, or certain disability benefits from the Railroad Retirement Board for 24 months.

When the time comes, you will automatically receive a Medicare card in the mail. If you don’t receive this card, contact your local Social Security office.

What Else Qualifies You for Medicare Disability Benefits?

In addition to the aforementioned disability, you can also qualify for Medicare if you have Lou Gehrig’s disease (ALS) or End-Stage Renal disease (kidney failure or ESRD). If you have ALS or ESRD, you do not have to wait the 24-month period of collecting benefits before you are eligible for Medicare. For ESRD, you will become eligible for Medicare 3 months after dialysis begins or after a kidney transplant. If you have ALS, your Medicare coverage starts when you begin collecting disability benefits.

If you have ESRD, you will not be automatically enrolled in Medicare. You will have to sign up through Social Security or the Railroad Retirement Board.

What Type of Medicare Coverage Do I Get with a Disability?

Once you qualify for Medicare through Social Security disability, you will receive all of the standard benefits of Medicare Parts A and B. This includes:
*Inpatient care in hospitals
*Inpatient rehabilitation facilities
*Long-term care hospitals
*Skilled nursing facilities
*Home health care services
*Hospice care
*Ambulance service
*Inpatient outpatient care
*Partial hospitalization
*Clinical research
*DME (durable medical equipment)

If you take any prescription drugs, it might be smart to also sign up for a Medicare Part D plan. If you qualify for automatic enrollment of Parts A and B, Part D might be the only plan you’ll need to sign up for. You must sign up for a Part D plan three months before the 25th month of your Social Security Disability benefits, during the 7-month period around your 65th birthday, or during Annual Enrollment Period from October 15th-December 7th.

Medicare does not cover all of your medical needs. In addition to Part D, you might want to sign up for a Medicare Supplement (Medigap) plan to fill the gaps in your Medicare coverage. Depending on the plan, Medicare Supplement plans can cover services such as Medicare Parts A and B coinsurance or copayments, foreign travel emergency, Medicare part A deductible, and more.

Nothing on this website should ever be used as a substitute for professional medical advice. You should always consult with your medical provider regarding diagnosis or treatment for a health condition, including decisions about the correct medication for your condition, as well as prior to undertaking any specific exercise or dietary routine.

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