You can enroll in Medicare before you’re 65 if you have a disability and meet certain other conditions. You can choose Medicare or a Medicare Advantage plan.
For many people under 65, an Advantage plan is the most cost-effective option.
Medicare Disability Eligibility
Most people on Medicare are 65 and older, but some younger people also qualify.
When you are under 65, you become eligible for Medicare if:
- You’ve received Social Security Disability Insurance (SSDI) checks for at least 24 months. At the end of the 24 months, you’ll automatically be enrolled in Parts A and B.
- You have End-Stage Renal Disease (ESRD) and need dialysis or a kidney transplant. You can get benefits with no waiting period by applying at your local Social Security office.
- Also, if you have Lou Gehrig’s Disease, you’ll automatically be enrolled when you begin receiving disability benefits.
If you’re under 65 and Medicare-eligible you can sign up for an Advantage plan.
Medicare Advantage Plan for Disabled Under 65
Most Social Security Disability Advantage plans combine Medicare coverage with other benefits like a prescription drug, vision, and dental coverage. Medicare Advantage plans can be either HMOs or PPOs.
You may have to pay a monthly premium, an annual deductible, and copays or coinsurance for each healthcare visit. Your costs will vary depending on your insurance company and the plan you choose.
You may also be eligible for a Medicare Advantage Special Needs Plan. These plans are only available to people who meet specific criteria, such as having a particular chronic and disabling health condition or being eligible for both Medicare and Medicaid.
A Special Needs Plan is designed around the healthcare needs of the people in the policy. The availability of this type of policy can vary by location.
Many people on Social Security Disability also qualify for their state’s Medicaid program. If you’re on Medicare and Medicaid, you can still sign up for an Advantage plan. The two programs together will usually cover almost all your healthcare costs.
If you’re under 65, here’s when you can enroll in Advantage Plans:
- During your Initial Enrollment Period, which begins three months before you enroll in Medicare and ends three months after the month, your benefits start.
- During the Annual Enrollment Period from October 15th-December 7th each year
You can also switch from one Advantage plan to another or drop Advantage coverage during the Medicare Advantage Open Enrollment Period from January 1st to March 31st.
Best Medicare Supplement Plans for Disabled Under 65
Medicare pays a large portion of the cost, and Medigap can help cover what Medicare doesn’t cover. But if you’re under 65, it can be hard to find an affordable Medigap plan.
While some states require companies to offer at least one Medigap plan to people under age 65, others do not. In some states, Medigap plans are only available to certain types of beneficiaries, such as people with end-stage renal disease.
In several states, you can’t buy a Medigap plan at all if you’re under 65. And rates tend to go up from one year to the next.
So, Medigap can be both hard to get and expensive if you’re under 65. Often, the best solution is an Advantage plan.
When you turn 65, you’ll qualify for the Medicare Supplement Open Enrollment Period. Then, you can get a policy without having to answer any questions about your health.
Social Security Disability Income and Medicare Part D
If you choose Medicare, you’ll need a Part D drug plan. You’ll pay a premium, and a copay or coinsurance.
Many people on Social Security Disability qualify for Extra Help with Part D costs. Eligibility for Extra Help is based on income and assets.
If you’re on Medicaid, you automatically qualify for Extra Help.
Get Help Finding the Right Plan For You
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