How disability affects your Medicare

Turning 65 is a landmark in itself, and it is also the age when you reach Medicare eligibility. In some cases, you may already be receiving Social Security benefits, but for those who are disabled, Medicare eligibility may differ.

Americans younger than 65 can receive Medicare benefits if they are considered disabled. Medicare disability benefits are closely related to Social Security benefits, and a person will be able to start Medicare coverage 24 months after they have started Social Security disability payments.

Automatic enrollment
Once you have received Social Security benefits for two years, you are automatically enrolled for Medicare. Social Security will enroll you in both Medicare Part A and B, which provides coverage for hospital care and doctor visits and services.

Your Medicare card will be automatically sent to you 22 months after you started receiving Social Security disability benefits. It is possible to defer enrolling in Medicare Part B, which requires its own monthly premium. If you wish to forego signing up for Part B, there are instructions on the Medicare card.

Definition of disabled
The Social Security Administration has its own specific definition for what qualifies a person as disabled. There is an SSA list of medical conditions that automatically qualify a person as disabled, but some conditions may be harder to prove and receive approval.

Under the current law, a person may not start receiving Social Security disability payments until they have been disabled for at least five months. Payments and benefits typically begin on the sixth month after approval. After that point, Medicare will kick in exactly two years later.

Other parts of Medicare
While the Social Security Administration will automatically enroll a person who is disabled and receiving SS benefits, they will only be enrolled for Original Medicare (Part A and B). Other parts of Medicare, including Medicare Advantage Plans and prescription drug plans, will require separate enrollment.

If you are disabled and are about to be automatically enrolled in Original Medicare, you can sign up for a Medicare Advantage Plan or prescription drug plan during a seven-month period starting three months before your 25th month of Social Security disability payments. The enrollment period will end three months after your 25th month. You can also make changes to these plans during the annual open enrollment period that runs from Oct. 15 through Dec. 7.

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