People who have a qualifying disability can sign up for Medicare before they turn 65.
People who have a qualifying disability can sign up for Medicare before they turn 65.
Even if you're not 65, you may qualify for Medicare if you qualify for Social Security Disability Insurance (SSDI) from the Social Security Administration (SSA) or disability benefits from the Railroad Retirement Board (RRB).
If you receive these disability benefits for 24 months, you'll be automatically enrolled in Medicare Part A and Part B at the start of the 25th month. If you have ALS, or Lou Gehrig's disease, you automatically get Part A and Part B the month your disability benefits begin.
If you're already 65 and receiving disability benefits, there's no difference in the way you would apply for Medicare, and you do not have to wait 24 months before enrolling.
If you haven't turned 65 and need to enroll in Medicare due to a disability, here's some information on how to apply for SSDI and Medicare, including what information you need and how to qualify.
How to apply for Medicare if you have a disability
Before you can apply for Medicare you must first be approved for disability benefits through either the SSA or RRB. Once you're approved, and after you receive those benefits for 24 months, you're automatically enrolled in Medicare Part A and Part B during month 25.
If you're automatically enrolled, you'll receive your red, white and blue Medicare card in the mail 3 months before your 25th month of receiving disability benefits.
However, there are some cases in which you don't have to wait a full 24 months before being enrolled in Medicare:
- If you are receiving disability benefits at least 4 months before you turn 65, you'll be automatically enrolled in Part A and Part B on the first day of the month you turn 65. You don't need to do anything to sign up.
- If you aren't receiving disability benefits for at least 4 months before turning 65, you'll need to enroll in Part A when you turn 65.
- If you have ALS, you'll automatically be enrolled in Part A and Part B during the first month your disability benefits begin.
- If you have end-stage renal disease (ESRD), you can choose to enroll in Part A and Part B if you're eligible.
To apply for Medicare, you can:
- Apply online at Social Security
- Visit your local Social Security office (Use the Office Locator and schedule an appointment as some offices are still closed to the public)
- Call the SSA at 1-800-772-1213 (TTY 1-800-325-0778)
If you worked for the railroad, call the RRB at 1-877-772-5772.
If you already have Part A and would like to enroll in Part B, complete an Application for Enrollment in Part B (CMS-40B).
Do you have to take Medicare Part B?
You do not have to enroll in Part B, but there are a few things to consider before deciding to delay enrollment.
Whether you should enroll in Part B often depends on the type of health coverage you have. Typically, you'll want to sign up for Part B as soon as you're eligible unless you have insurance from your or your spouse's employer. If you're eligible for Part B and don't join Medicare AND you don't have other creditable coverage, you may have to pay a late enrollment penalty once you do sign up.
If you were automatically enrolled in Part A, you'll also be automatically enrolled in Part B. If you don't want Part B, follow the instructions that come with your Medicare card to disenroll.
To help decide whether you should sign up for Part B when you're first eligible, you can find your unique situation on Medicare.gov.
How to apply for Social Security disability benefits
If you worked long enough and paid Social Security taxes on your earnings, you're eligible to qualify for SSDI or Supplemental Security Income (SSI). While these two programs are different, they both provide or pay benefits to those who have disabilities.
You can apply if you're unable to work because of a medical condition that's expected to last at least 12 months or will result in death.
How to apply for SSDI
First, you'll want to gather all the information and documentation you'll need for your application. Then, you'll complete your application for disability benefits.
Once your application is submitted, the SSA will review it to ensure you meet the requirements for disability benefits, check that you've worked enough years to qualify, evaluate any current work activities, and process your application. They may reach out to you with additional questions or documentation.
After the application is processed, it's forwarded to the Disability Determination Services office in your state and they decide if you're eligible. You'll then receive a letter in the mail with the SSA's decision, or you can check the status of your online application using your my Social Security account.
Where to apply for SSDI
There are a few ways you can apply for SSDI.
- Online: Start your application on the Apply for Benefits page and agree to the Terms of Service. Review the Getting Ready section to ensure you have the information and documentation you need to apply. Then Start a New Application, fill out the questions, and complete the application.
- In person, at your local Social Security office.
- By calling the SSA at 1-800-772-1213 (TTY 1-800-325-0778).
What information do you need to apply for disability?
Preparing ahead of time to complete the disability benefits application can help make the process smoother and quicker. There is a variety of information and documentation you'll need in order to complete the application.
Here are a few general things you should prepare.
Information about you
- Date and place of birth
- Social Security number
- Name, Social Security number, and date of birth of your current spouse, as well as any former spouses
- Dates and places of marriage and dates of divorce or death for any current or former spouse
- Names and dates of birth of children younger than 18
- Bank account routing transit number and account number
Information about your medical condition
- Name, address, and contact information of someone who knows your medical condition
- Information about your medical condition or injury, such as contact information and dates of treatment for all doctors, hospitals and clinics, names of medicines you're taking, and names and dates of medical tests you've had, as well as who ordered them
Information about your work
- How much you earned last year and this year
- Name and address of your employer
- Beginning and end dates of any active military duty
- Jobs you've had in the past 15 years (prior to being unable to work)
- Information about workers' compensation or other benefits you filed
- Birth certificate (must be original)
- Proof of U.S. citizenship or lawful alien status (must be original)
- U.S. military discharge papers (if you were active prior to 1968)
- W-2 forms and/or self-employment tax returns for last year
- Medical evidence, such as medical records, reports, and test results
- Award letters, pay stubs, settlement agreements, or other proof of temporary or permanent workers' compensation or similar benefits
Don't forget the Initial Enrollment Period
Even if you're automatically enrolled in Part A and Part B, you'll want to be sure you know when your Initial Enrollment Period (IEP) is. During your IEP, you can join, switch, or drop a Medicare health plan, a Medicare Advantage plan (Part C), or a Medicare Part D prescription drug plan.
Your IEP happens when you first become eligible for Medicare.
- If you're eligible for Medicare because you have a disability and you're not yet 65, your IEP is the 7-month period surrounding your eligibility. This starts the 3 months before your 25th month of receiving disability benefits, which is when you'll receive your Medicare card. It also includes the 25th month and the 3 months after.
- If you're eligible for Medicare because of a disability but you turn 65, your IEP is the 3 months before you turn 65, the month of your birthday, and the 3 months after.
While enrolling in a Part C Medicare Advantage plan is optional, you must enroll in Part D or have other creditable drug coverage. This means your drug plan compares to Medicare in terms of both coverage and cost. Otherwise, you may have to pay a late enrollment penalty.
Other ways to qualify for Medicare before turning 65
There are other ways you can qualify for Medicare prior to your 65th birthday.
The first way is with a diagnosis of ALS. In this case, you'll automatically get Part A and Part B at the same month your disability benefits begin. You don't need to sign up and you'll receive your Medicare in the mail the month before your disability benefits begin.
However, you do still have to complete the process to enroll in Social Security benefits before you receive Medicare coverage.
Another way you may qualify is if you have end-stage renal disease (ESRD). If you're eligible for Medicare because of ESRD, you can choose to enroll in Part A and Part B. You are not automatically enrolled, so you would have to apply through Medicare.
With ESRD, it's recommended that you enroll in both Part A and Part B to get the full benefits under Medicare that cover dialysis and kidney transplant services. Even if you choose not to enroll, you won't have to pay a late enrollment penalty.
For more information, please see our article about how long it takes to get Medicare after being approved for disability.
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