Under 65 with Lou Gehrig’s Disease: What are Your Medicare Coverage Options?

Last Updated : 09/27/20195 min read

You may know that Medicare is available to qualified people 65 and over, but not everyone knows about Medicare for disabled people under 65 for those who qualify. If you have Lou Gehrig’s disease, for example, you might be eligible for Medicare before age 65.

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Medicare for disabled people under 65: What is Lou Gehrig’s disease?

Lou Gehrig’s disease is amyotrophic lateral sclerosis (ALS), reports the National Library of Medicine. It’s a progressive disease that attacks the nervous system. Gradually, ALS patients lose muscle control.

Some famous people have had ALS, such as the person it was named for – Lou Gehrig, the baseball player. Scientist Stephen Hawking was another.

Who qualifies for Medicare for disabled under 65?

Some people with a disability or illness may qualify for Medicare under age 65. Anyone with a qualifying disability who receives Social Security Disability Income (SSDI) for at least 24 months in a row is typically eligible for Medicare. However, there are two conditions for which the 24-month waiting period is waived: Lou Gehrig’s disease and end-stage renal disease (ESRD).

ESRD is permanent kidney failure that requires regular dialysis or a kidney transplant.

How do I apply for Medicare for disabled people under 65?

If you qualify for Medicare for disabled people under 65, here’s how you get enrolled in Medicare Part A and Part B.

  • ALS: You’re generally automatically enrolled in Medicare Part A and Part B the same month that you qualify for Social Security disability benefits.
  • ESRD: You are usually not signed up for Medicare automatically. You’ll need to sign up for Medicare through the Social Security Administration (SSA). You might need to have worked a certain length of time to be eligible for Medicare, if you’re not already receiving SSA benefits.
  • Most other disabilities: For most qualifying illnesses or disabilities, you’re automatically enrolled in Medicare. It happens after you’ve been receiving disability benefits for 24 months in a row. You’re generally signed up at the start of the 25th month.

You can visit www.socialsecurity.gov to check the status of your application or to contact a representative about your application.

What types of Medicare coverage is available for people under 65?

If you qualify for disability and Medicare, you might have other Medicare coverage options besides Original Medicare (Part A and Part B).

  • You might be able to get your Medicare Part A and Part B benefits through a Medicare Advantage plan. Available from private, Medicare-approved insurance companies, Medicare Advantage plans deliver your Part A and Part B benefits, and usually include prescription drug coverage.

Many Medicare Advantage plans also include additional benefits not available under Original Medicare. For example, your plan may cover routine vision and dental care. Some plans are also offering an expanded list of home health benefits available for the first time in 2019. Plans in your area may cover services such as non-medical transportation to and from medical visits, home meal delivery, and even over-the-counter medications and devices.

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If you have ESRD, you might not qualify for a Medicare Advantage plan. You might still qualify for a kind of Medicare Advantage plan called a Medicare Special Needs Plan (SNP). There’s a type of SNP designed for people with ESRD. Feel free to contact one of eHealth’s licensed insurance agents to see if that kind of SNP is available in your area.

  • If you stay with Original Medicare, you might want to enroll in a stand-alone Medicare Part D prescription drug plan. You may also be able to buy a Medicare Supplement insurance plan, which may help cover many of your out-of-pocket costs under Medicare Part A and Part B. However, not every state requires insurance companies to sell Medicare Supplement insurance plans to people under 65. Read more about Medicare Supplement insurance.

How much is Medicare for disabled under 65?

You may qualify for premium-free Medicare Part A if you have at least 10 years of work history paying Medicare taxes. Most people pay a monthly premium for Part B, which you will have to pay even if you choose a Medicare Advantage plan. Depending on your financial situation, you may qualify for help with your Part B premiums.

Medicare Advantage plans may have an additional monthly premium, although there may be $0-premium plans available in your area. If you enroll in a stand-alone Medicare Part D prescription drug plan, and/or a Medicare Supplement insurance plan, you may pay separate monthly premiums.

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The product and service descriptions, if any, provided on these Medicare.com Web pages are not intended to constitute offers to sell or solicitations in connection with any product or service. All products are not available in all areas and are subject to applicable laws, rules, and regulations.

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