Medicare is available for most people age 65 or older, but also for certain people with disabilities who are under age 65. To be eligible, you must have received Social Security Benefits for 24 months, or have End-Stage Renal Disease or Lou Gehrig’s Disease. If you are disabled and wondering if you qualify for Medicare Part A and Part B, here’s some important information that can help.
Medicare With a Disability
Even if you are under 65, enrollment in Medicare Part A and Part B with a disability is automatic. After receiving Social Security benefits or Railroad benefits for 24 months, you will receive your Medicare card in the mail. Look for the card to arrive three months before your 25th month of disability. Note: if you have Lou Gehrig’s Disease, enrollment is automatic, but Medicare benefits are available after your first month of disability. Enrollment in both Part A and Part B is automatic. However, you can opt out of Part B coverage if you choose. Instructions on the back of the card explain how to do so. If you choose not to accept Part B before age 65, you will automatically be enrolled again when you turn 65.
End-Stage Renal Disease (ESRD)
If you have ESRD, you can sign up for Medicare before 65 if you need regular dialysis, or have had a kidney transplant, and meet one of the following:
You worked the required amount of time under Social Security or Railroad Retirement Board.
You are eligible to receive or already receiving Social Security or Railroad Retirement Benefits.
You are the spouse or dependent child of a person who meets the requirements above.
If you are eligible for Medicare because of ESRD, enrollment is not automatic and you will need to enroll in Part A and Part B by contacting your local Social Security office. Benefits typically start on the first day of the fourth month of your dialysis treatments. If you’re covered by an employer group health plan, your Medicare coverage will still start the fourth month of dialysis treatments. Your employer group may pay for the first 3 months of dialysis.
Medicare benefits may start during the first month of dialysis
You participate in a Medicare-certified training program to learn how to administer dialysis treatments from home and are expected to be able to do so. Dialysis treatments continue through the waiting period. Medicare benefits will end 12 months after you stop dialysis treatments or 36 months after you have a kidney transplant. Coverage can be extended if you start dialysis or get a kidney transplant within 12 months of stopping dialysis, or 36 months after receiving a new kidney.
References:
Medicare with a disability: https://www.medicare.gov/people-like-me/disability/signing-up-for-part-b-disability.html
Medicare with ESRD: https://www.medicare.gov/people-like-me/esrd/getting-medicare-with-esrd.html#collapse-3178
MUC56-2017-BCBS
