Can I get Medicare Coverage After Being Exposed to an Environmental Health Hazard?

Tamera Jackson by Tamera Jackson | Licensed since 2007
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This article was updated on: 09/10/2018

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Do you know that if you have a disability related to an environmental health hazard you might be eligible for Medicare coverage? The great majority of Medicare beneficiaries, about 82% in 2013, are age 65 and older, according to the Medicare Payment Advisory Commission.

However, there are several ways to qualify for Medicare coverage if you are under 65, according to the Centers for Medicare and Medicaid Services (CMS):

  • You are awarded Social Security disability income for 25 months
  • You have end stage renal disease (ESRD)
  • You have Amyotrophic Lateral Sclerosis (ALS)
  • You have been affected by a certified environmental health hazard (EHH)

With most disabilities there is a two-year waiting period to receive Medicare benefits, but for ESRD, ALS, and environmental health hazards, the 24-month waiting period is waived.

What is a certified environmental health hazard?

The Center for Disease Control (CDC) and Prevention’s National Center for Environmental Health (NCEH) aims to protect people from environmentally-related illness, disability and death. According to the CDC, some environmental health hazards may include:

  • Carbon monoxide is an odorless, colorless gas that can kill you
  • Mold is fungi that can be found indoors and outdoors. Mold can cause upper respiratory tract symptoms such as cough and wheeze in otherwise healthy people and asthma symptoms in people with asthma
  • Unclean drinking water could contain giardia, legionella, norovirus, shigella, campylobacter, copper, salmonella, hepatitis A, cryptosporidium, e. coli, excess fluoride, and other contaminates
  • Chemical exposure to chemicals that may be systemic toxins, carcinogens, immunological agents, reproductive toxicants or asthmagens can cause illness. Chemicals can also be explosive and flammable.
  • Asbestos may cause diseases including asbestosis (a chronic lung disease), pleural disease, lung cancer, and mesothelioma
  • Radiation exposure can increase risk of cancer later in life

Generally, not all exposure to environmental health hazards will qualify you for Medicare coverage. You may have to get a doctor to verify that you developed a health condition directly as a result of the exposure to the environmental health hazard. If you recover from your condition related to an environmental health hazard, Social Security will determine if you are still eligible for Medicare coverage.

What type of Medicare coverage am I eligible for?

If you have Medicare coverage as result of being exposed to an environmental health hazard, you are eligible for all four parts of Medicare.

  • Medicare Part A may cover hospital inpatient care as well as skilled nursing facility care, hospice care and some home health care
  • Medicare Part B may cover doctor visits, outpatient medical care, some vaccinations, durable medical equipment and mental health services
  • Medicare Part D may cover prescription drugs
  • Medicare Part C (Medicare Advantage) covers all the benefits of Medicare Part A and Part B and sometimes Part D as well

If you are under 65, you may not be able to enroll in a Medicare Supplement (Medigap) plan unless your state has a specific provision for it. Federal law does not require private insurance companies to sell Medicare Supplement plans to people under 65.

How can I apply for Medicare coverage after being affected by an environmental health hazard?  

People age 65 and older may be automatically enrolled in Original Medicare, but if you are under 65 and affected by a certified environmental health hazard you have to apply to enroll in Medicare Part A and Part B. To find out more about if your circumstance qualifies you for Medicare, contact your State Health Insurance Assistance Program (SHIP) or call Social Security at 1-800-772-1213 7:00 AM-7:00 PM in each time zone TTY: 1-800-325-0778.

If you have other questions about Medicare coverage of environmental health hazards, I’d be happy to help. To set up a time to talk one-on-one about your Medicare needs, click the link below. You can also request an email from me with personalized Medicare information; you’ll find that link below as well. To start browsing on your own, click the Compare Plans button on this page.

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