Medicare Blog

how long to wait for medicare after disability

by Prof. Garth Nolan IV Published 2 years ago Updated 1 year ago
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How Long Does It take to Get Medicare Coverage Through Social Security Disability (SSDI)?

  • When Medicare Starts. In general, the two-year waiting period for Medicare is calculated from your date of SSDI entitlement—when you are eligible to start receiving monthly benefits.
  • Exceptions to the Two-Year Waiting Period for Medicare. There are a couple of exceptions to the two-year wait for Medicare. ...
  • Medicaid in the Interim. ...

two years

Full Answer

When can I get Medicare if I am on disability?

You may also be eligible for Medicare before turning 65 if you are age 18 or older and at least one of the following applies: Collect Social Security Disability Insurance (SSDI) for 24 months Have amyotrophic lateral sclerosis, better known as Lou Gehrig's disease Have end-stage renal disease

Can you get Medicare early if you are disabled?

If you have been approved for Social Security Disability Insurance (SSDI) you will receive Medicare 24 months from the date of your disability, and given the five month waiting period for SSDI this means that even if you are approved for SSDI, you could …

How long does it take to get SSI back pay?

Nov 18, 2019 · In such a case, the earliest you can be eligible for Medicare is one year after applying for Social Security Disability. But disability applicants who apply for benefits only when they become disabled and not before, will more likely be eligible for Medicare two and a half years after applying for disability depending on the state in which you reside .

How long should you wait before you apply for disability?

Jul 16, 2020 · How long do people on disability have to wait to become eligible for Medicare? Once you have collected SSDI payments for two years, you will become eligible for Medicare. You won’t even have to sign up—Medicare will automatically enroll you in Part A and Part B and mail your Medicare card to you shortly before your coverage begins.

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What is Medicare?

Medicare is health insurance provided by the Federal Government. Medicare is primarily for workers who are 65 years or older, however, other disabled claimants, including those with end-Stage Renal Disease (permanent kidney failure treated with dialysis or a transplant) can also get Medicare.

When do I get my Medicare benefits?

Many individuals, especially those who are unemployed, may need medical insurance. Many wonder what options are available to them, but unless you are elderly or disabled, Medicare is not available.

Why did the SSA create a Medicare waiting period?

There were several reasons the Medicare waiting period was implemented.

What happens to Medicare coverage if I return to work?

Frequently we get questions from SSDI recipients who want to return to work but who do not want to lose their Medicare coverage. According to the SSA, you may receive “at least 93 months of hospital and medical insurance after the trial work period as long as you still have a disabling impairment.”

Questions about Medicare

If you have questions about this coverage, you can contact Medicare toll-free at 1-800-MEDICARE (1-800-633-4227) to speak to a Medicare Customer Service Representative.

How long do you have to wait to get Medicare?

You have to wait two years after you are entitled to disability benefits to get Medicare unless you fit into an exception. All Social Security disability insurance (SSDI) recipients can receive Medicare coverage two years after the first month they are eligible for their monthly disability benefits. This does not mean that every individual who is ...

How long is the waiting period for Medicare?

In general, the two-year waiting period for Medicare is calculated from your date of SSDI entitlement—when you are eligible to start receiving monthly benefits. This is usually the date your disability began, plus five months (due to the five-month waiting period for SSDI).

How long does it take for Medicare to start?

On the other hand, for disability applicants who apply for benefits only when they become disabled, and not before, the date that their Medicare coverage will start is more likely to be two years and five months after they apply for disability.

When will Makayla get her SSDI?

Makayla applies for disability on August 1, 2019, the day after she quit work due to her disability. Thirteen months later, on September 1, 2020, she is approved for SSDI benefits with a disability onset date of August 1, 2019. She is eligible for retroactive benefits only going back to January 1, 2020, five months after her disability onset date. Because her date of entitlement is January 1, 2020, she'll be eligible for Medicare on January 1, 2022. Note that her eligibility for Medicare starts two years and five months after her application date.

When will Isaiah be eligible for Medicare?

But he is eligible for retroactive benefits only going back to October 1, 2018, five months after his disability onset date. Because his date of entitlement is October 1, 2018, he'll be eligible for Medicare on October 1, 2020. Note that his eligibility for Medicare starts only 14 months after his application date, and only one month after his decision date.

When does Medicare cover end stage renal disease?

If you require ongoing dialysis or a kidney transplant, Medicare coverage can begin the third month after the month in which your dial ysis began. Amyotrophic lateral sclerosis (ALS). Individuals with amyotrophic lateral sclerosis (ALS) qualify for Medicare as soon as they are eligible ...

Can I get medicaid with low income?

Those with low income and low assets may qualify for the Medicaid program during the two-year waiting period for Medicare. States set their own rules regarding Medicaid eligibility, but those granted SSI at the same time as SSDI automatically qualify for Medicaid.

How long does it take to get Medicare if you appeal a decision?

The result: your wait for Medicare will be shorter than two years.

How long does a disability last?

The government has a strict definition of disability. For instance, the disability must be expected to last at least one year. Your work history will also be considered—usually, you must have worked for about 10 years but possibly less depending on your age.

What is ESRD in Medicare?

ESRD, also known as permanent kidney failure, is a disease in which the kidneys no longer work. Typically, people with ESRD need regular dialysis or a kidney transplant (or both) to survive. Because of this immediate need, Medicare waives the waiting period. 2

What to do if your income is too high for medicaid?

If your income is too high to qualify for Medicaid, try a Medicare Savings Program (MSP), which generally has higher limits for income. As a bonus, if you qualify for an MSP, you automatically qualify for Extra Help, which subsidizes your Part D costs. Contact your state’s Medicaid office for more information.

What conditions are considered to be eligible for Medicare?

Even though most people on Social Security Disability Insurance must wait for Medicare coverage to begin, two conditions might ensure immediate eligibility: end-stage renal disease (ESRD) and Lou Gehrig’s disease (ALS).

When will Medicare be available for seniors?

July 16, 2020. Medicare is the government health insurance program for older adults. However, Medicare isn’t limited to only those 65 and up—Americans of any age are eligible for Medicare if they have a qualifying disability. Most people are automatically enrolled in Medicare Part A and Part B once they’ve been collecting Social Security Disability ...

Does Medicare cover ALS?

Medicare doesn’t require a waiting period for people diagnosed with ALS, but they need to qualify based on their own or their spouse’s work record. 3

How long do you have to wait to get Medicare if you have Social Security Disability?

Social Security Disability Insurance (SSDI) & Medicare coverage. If you get Social Security Disability Income (SSDI), you probably have Medicare or are in a 24-month waiting period before it starts. You have options in either case.

What is SSI disability?

Supplemental Security Income (SSI) Disability & Medicaid coverage. Waiting for a disability status decision and don’t have health insurance. No disability benefits, no health coverage. The Marketplace application and disabilities. More information about health care for people with disabilities.

Can I enroll in a Medicare Marketplace plan if I have Social Security Disability?

You’re considered covered under the health care law and don’t have to pay the penalty that people without coverage must pay. You can’t enroll in a Marketplace plan to replace or supplement your Medicare coverage.

Can I keep my Medicare Marketplace plan?

One exception: If you enrolled in a Marketplace plan before getting Medicare, you can keep your Marketplace plan as supplemental insurance when you enroll in Medicare. But if you do this, you’ll lose any premium tax credits and other savings for your Marketplace plan. Learn about other Medicare supplement options.

Can I get medicaid if I have SSDI?

You may be able to get Medicaid coverage while you wait. You can apply 2 ways: Create an account or log in to complete an application. Answeryes” when asked if you have a disability.

Can I get medicaid if I'm turned down?

If you’re turned down for Medicaid, you may be able to enroll in a private health plan through the Marketplace while waiting for your Medicare coverage to start.

How long do you have to wait to get Medicare if you are 65?

A. It’s true that most people* under age 65 who qualify for Social Security disability must wait 24 months before becoming eligible for Medicare. Consumer advocates, including AARP, have long opposed this two-year delay.

Do you have to buy extra insurance for Medicare?

Under the law, people with Medicare are regarded as fully insured and not required to buy extra insurance. * Although most people must wait two years for Medicare after qualifying for Social Security disability benefits, there are exceptions.

Can you get Medicare for Lou Gehrig's disease?

People with amyotrophic lateral sclerosis — better known as Lou Gehrig’s disease and those with permanent ki dney failure can get Medicare coverage without a wait after diagnosis. Patricia Barry is a senior editor at the AARP Bulletin.

How long is a person eligible for Medicare?

Everyone eligible for Social Security Disability Insurance (SSDI) benefits is also eligible for Medicare after a 24-month qualifying period. The first 24 months of disability benefit entitlement is the waiting period for Medicare coverage. During this qualifying period for Medicare, the beneficiary may be eligible for health insurance ...

How long can you keep Medicare after you return to work?

Answer: As long as your disabling condition still meets our rules, you can keep your Medicare coverage for at least 8 ½ years after you return to work. (The 8 ½ years includes your nine month trial work period.) Question: I have Medicare hospital Insurance (Part A) and medical insurance (Part B) coverage.

Why does Bill have Medicare?

Example: Bill has Medicare coverage because of permanent kidney failure. He also has group health plan coverage through the company he works for. His group health coverage will be his primary payer for the first 30 months after Bill becomes eligible for Medicare. After 30 months, Medicare becomes the primary payer.

How to order a publication from Medicare?

Answer: You can view, print, or order publications online or by calling 1-800-MEDICARE (1-800-633-4227). The fastest way to get a publication is to use our search tool and then view and print it. If you order online or through 1-800-MEDICARE, you will receive your order within 3 weeks. The link to search publications is at: http://www.medicare.gov/Publications/home.asp

Is Medicare a secondary payer?

Answer: Medicare may be the "secondary payer" when you have health care coverage through your work. See the information under "Coordination of Medicare and Other Coverage for Working Beneficiaries with Disabilities" about when Medicare is a "secondary payer or primary payer".

Does Medicare pay for non-VA hospital?

If the VA authorizes services in a non-VA hospital, but doesn't pay for all of the services you get during your hospital stay, then Medicare may pay for the Medicare-covered part of the services that the VA does not pay for. Example: John, a veteran, goes to a non-VA hospital for a service that is authorized by the VA.

Does Medicare pay for the same service?

Medicare cannot pay for the same service that was covered by Veterans benefits, and your Veterans benefits cannot pay for the same service that was covered by Medicare. You do not have to go to a Department of Veterans Affairs (VA) hospital or to a doctor who works with the VA for Medicare to pay for the service.

How long do you have to wait to receive your first SSDI payment?

Generally, if your application for Social Security Disability Insurance (SSDI) is approved, you must wait five months before you can receive your first SSDI benefit payment. This means you would receive your first payment in the sixth full month after the date we find that your disability began.

When will I get my first SSDI?

Your first benefit would be paid for the month of December 2020, the sixth full month of disability. However, there is no waiting period if your disability results from amyotrophic lateral sclerosis (ALS) and you are approved for SSDI benefits on or after July 23, 2020.

How long does Medicare cover ALS?

Medicare Coverage If You're Disabled. We automatically enroll you in Original Medicare (Parts A and B) after you get disability benefits for two years. However, if your disability results from ALS, Medicare coverage begins sooner, generally the first month you are eligible for disability benefits.

What is Medicare Part D?

Medicare Part D (Medicare prescription drug coverage) helps pay for medications doctors prescribe for treatment. For more information on the enrollment periods for Part D, we recommend you read Medicare's How to get prescription drug coverage page.

What is Medicare Advantage Plan?

Medicare Advantage Plan (previously known as Part C) – people with Medicare Parts A and Part B can choose to receive all of their health care services through plans that are offered by private companies and approved by Medicare.

What is Medicare coverage?

Medicare Coverage If You're Disabled 1 Medicare Part A (Hospital Insurance) helps pay for inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care. The taxes you paid while you were working financed this coverage. It’s provided at no cost to you. 2 Medicare Part B (Medical Insurance) helps pay doctors' services, outpatient care, some medical supplies, and other preventive services. You will need to pay a monthly premium for this coverage if you want it.

When will SSDI pay in 2020?

We would pay your first benefit for the month of December 2020, the first full month of disability. We pay SSDI benefits in the month following the month for which they are due. This means that the benefit due for December 2020 would be paid to you in January 2021, and so on.

How long do you have to wait to get Medicare if you have SSDI?

Most SSDI recipients need to wait 24 months before Medicare coverage begins. However, there are exceptions. For some life-threatening conditions, the waiting period is waived and coverage begins sooner. You won’t need to wait the full 2 years if you have ASL or ESRD.

How long do you have to be on Medicare to get disability?

Takeaway. You’ll be automatically enrolled in Medicare once you’ve received Social Security disability benefits for 24 months. The waiting period is waived if you have amyotrophic lateral sclerosis (ALS) or end stage renal disease (ESRD). There is no Medicare waiting period if you’re over 65. You can apply for other types ...

How long is Medicare coverage?

Medicare coverage is available to people under age 65 who receive Social Security disability benefits. Most people are automatically enrolled after a 2-year waiting period. If you have ESRD or ALS, the 2-year waiting period will be waived. You can take advantage of programs such as Medicaid, COBRA, or the Health Insurance Marketplace ...

How long do you have to wait to get dialysis?

You’ll likely need dialysis treatments when you have ESRD, and you may be considered for a kidney transplant. You don’t need to wait the full 2 years to receive Medicare coverage if you have ESRD. Your Medicare coverage will begin the first day of the fourth month of your dialysis treatment.

When does Medicare start paying for dialysis?

Your Medicare coverage will begin the first day of the fourth month of your dialysis treatment. You can get coverage as soon as your first month of treatment if you complete a Medicare-approved training program to do your own at-home dialysis treatment.

When can I apply for medicare if I am 64?

This means that if you apply for SSDI benefits and are approved when you’re 64, your Medicare benefits will begin at 65, just like they would have if you didn’t receive SSDI.

Is there a waiting period for Medicare?

There is no Medicare waiting period if you’re over 65. You can apply for other types of coverage during the waiting period. People who receive Social Security Disability Insurance (SSDI) are eligible for Medicare. In most cases, you’ll be automatically enrolled in Medicare after a two-year waiting period. Your Medicare coverage will begin the first ...

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