How to Apply for Medicare Disability Benefits

How to Apply for Medicare Disability Benefits

You can apply for Social Security disability benefits 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.

If you have worked long enough and paid Social Security taxes on your earnings, you're eligible to qualify for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI). While these two programs are different, they both provide or pay benefits to those who have a qualifying disability.

Once you are approved for disability benefits, you may also be eligible for Medicare. If you're already 65 or older when you begin receiving disability benefits, there's no difference in the way you would apply for Medicare. You also don't have to wait 24 months to qualify, because you've already aged into the program If you aren't yet 65 and collect disability benefits, you will qualify for Medicare after 24 months. Those who aren't yet 65 but qualify for Medicare due to ALS or ESRD do not have the same 24-month waiting period.

The following information explains how and where to apply for Medicare disability benefits, what information and documentation you'll need for your application, and additional details about qualifying.

How to apply for Social Security disability benefits

To qualify for Medicare due to a disability, you must first apply and be approved for SSDI or SSI disability benefits prior to enrolling in Part A and Part B.

How to apply for SSDI

To apply for SSDI,

Gather all the information and documentation you'll need for your application

Complete the application for disability benefits

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.

  • Note that you can only apply online if you're 18 or older, are not currently receiving benefits, and have not been denied for disability in the past 60 days.

In person, at your local Social Security office. Use the Office Locator and contact your local office prior to visiting because some offices are still closed to the public.

By calling the SSA at 1-800-772-1213 (TTY 1-800-325-0778).

Once your application is submitted, the Social Security Administration (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.

How to apply for Medicare if you have a disability

You can apply for Medicare once you're approved for disability benefits through either the SSA or Railroad Retirement Board (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 already 65, the process for applying for Medicare is no different whether you're receiving disability benefits or not. To apply, you can:

  • Apply online at Social Security
  • Visit your local Social Security office
  • 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.

For more information, please see our article about how long it takes to get Medicare after being approved for disability.

If you already have Part A and would like to enroll in Part B, complete an Application for Enrollment in Part B (CMS-40B).

When is the 24-month waiting period for Medicare disability benefits waived?

There are some cases in which you don't have to wait a full 24 months before being enrolled in Medicare. If you:

Receive 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.

  • Please note, if you receive disability benefits for at least 4 months before turning 65, you'll need to enroll in Part A and/or Part B when you turn 65.

Have ALS, you'll automatically be enrolled in Part A and Part B during the first month your disability benefits begin. You don't need to sign up and you'll receive your Medicare card 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.

Have end-stage renal disease (ESRD), you can choose to enroll in Part A and Part B if you're eligible. You are not automatically enrolled, so you would have to apply for Medicare.

Whether you age into Medicare or qualify due to a disability, you always apply through the Social Security Administration.

What information do you need to apply for disability?

Preparing ahead of time to complete the disability benefits application can help make the process go more smoothly and quickly. There is a variety of information and documentation you'll need in order to complete the application.

Here are a few general items 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

Documents

  • 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

We can help you understand your Medicare options

Our licensed insurance agents can help you understand your Medicare plan options. Just call us toll-free to get started. You can also use our Find a Plan tool to review Medicare plan options in your area.

Additional resources

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