Can You Get Medicare If You Have Disability Entitlement?

Jory Cross by Jory Cross | Licensed since 2012
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This article was updated on: 09/16/2018

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You can still get some types of Medicare coverage if you are entitled to disability benefits and under 65. The process of enrolling in Original Medicare Part A and Part B is virtually the same as for individuals who do not have disability entitlement. See the following questions and answers for more information.

If I’m not 65 yet but I have a disability; can I get Medicare coverage?

If you get Social Security or Railroad Retirement Board disability benefits, you will generally be automatically enrolled in Original Medicare (Part A and Part B) after you’ve received disability for 24 months. Your Medicare card will arrive in the mail about three months before your 25th month of disability income. Instructions will come with the card if you want to decline your Part B benefits and only keep your premium-free Part A.

Note that if you are under 65 and have Amyotrophic Lateral Sclerosis (ALS or Lou Gehrig’s disease), you are generally eligible for Medicare benefits the first month you get your disability benefits from Social Security or the Railroad Retirement Board.

I’m under 65, have a disability, and only have Part A; when can I get Part B?

If you are still receiving disability benefits when you turn 65, Medicare will automatically enroll you in Part B. You’ll receive an Initial Enrollment Package about three months before your 65th birthday which includes your new Medicare card.

Can I get Medicare Part D coverage for prescription drugs if I’m on disability?

If you are under age 65 and receiving disability benefits, you are eligible to enroll in a Medicare Part D Prescription Drug Plan after your 24th month of disability payments. At any time during the seven-month period beginning three months before your 25th month of disability and ending three months after the 25th month, you may enroll in Medicare Part D coverage for prescription drugs as long as you have Medicare Part A and/or Part B and live in the plan’s service area.

Keep in mind, you may owe a late-enrollment penalty with your monthly premium for as long as you are enrolled if you don’t enroll in a Medicare Part D Prescription Drug Plan when you are first eligible unless you have other creditable prescription drug coverage.

Can I enroll in Medicare Advantage if I have a disability?

If you do not have end-stage renal disease (ESRD), in most cases you can enroll in a Medicare Advantage plan during the same time frames listed above for Part D prescription drug coverage, provided you live in the plan’s service area. If you do have ESRD, you may qualify for a Medicare Advantage Special Needs Plan (SNP) if one is available where you live. You also may be able to keep your Medicare Advantage plan if you are enrolled in it when you develop ESRD.

Medicare Advantage plans often provide more coverage than Original Medicare for individuals with disabilities, including benefits for routine vision, dental, and hearing care. Most also include Part D coverage for prescription drugs. In many cases, you may have lower copayments and deductible amounts, as well.

Keep in mind, however, that not all plan types and benefits may be available in all locations. You do need to keep paying your Part B premiums plus any additional plan premiums for as long as you are covered.

Can I get a Medicare Supplement (Medigap) plan if I have a disability and I’m under 65?

Federal law does not require insurance companies to sell Medicare Supplement plans to people under age 65 who have qualified for Medicare through a disability. However, some states require that insurance companies sell at least one kind of Medicare Supplement policy to qualified beneficiaries under age 65 with disabilities.

Want to know more about how your Medicare coverage and disability benefits? I am happy to give you more information and answer your questions. If you prefer, you can schedule a phone call or request an email by clicking on the buttons below. You can also find out about plan options in your area by clicking the Compare Plans button.

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.

The purpose of this communication is the solicitation of insurance.  Contact will be made by an insurance agent/producer or insurance company.

Medicare Supplement insurance plans are not connected with or endorsed by the U.S. Government or the Federal Medicare program.

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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