If you are under 65 and eligible for Medicare because of a disability, you can enroll in a Medicare Advantage plan instead of Original Medicare Parts A and B. A Medicare Advantage plan may provide more coverage than you would get with Original Medicare alone, at a relatively affordable rate.
Medicare Advantage and Disability
Original Medicare coverage includes Part A, for hospitalization, and Part B, for other medical costs. Many people who have Original Medicare coverage also buy a Medicare Part D prescription drug plan to cover prescriptions, and a Medicare Supplement plan to cover deductibles, copays and coinsurance that Medicare doesn’t cover.
Medicare Advantage, also known as Medicare Part C, is “all in one” Medicare coverage sold by private insurance companies authorized by Medicare. Medicare Advantage plans provide at least as many benefits as Medicare Parts A and B, and sometimes more.
Many Medicare Advantage plans also cover prescriptions. Because premiums, deductibles, copays and coinsurance are set by the insurance companies, they can vary greatly.
Original Medicare Plus Medicare Supplements for Disabled People Under 65
Original Medicare plus a Medicare Supplement will usually provide broader coverage than a Medicare Advantage plan. The most popular Medicare Supplement plan, Plan F, covers almost everything that Medicare doesn’t cover, including the 20 percent Medicare Part B coinsurance, Part A and B deductibles, and additional days of hospitalization.
But if you are under 65, there’s a catch: the government does not require states to offer Medicare Supplement plans to people under 65, and they may not be available in your state. In addition, premiums are much higher for people under 65 than they are for people 65 and older, and they tend to have high yearly increases.
This means that if you’re under 65, it may be hard for you to get or afford Medicare Supplement coverage. A Medicare Advantage plan may be a better alternative than just having Medicare Parts A and B alone.
Medicare Advantage Eligibility for Disabled People
If you are under 65 and receiving Social Security or railroad retirement benefits because of a disability, you will automatically be enrolled in Medicare after you have received benefits for 24 months. There are two specific conditions that can make you eligible for Medicare sooner:
- If you have ALS, also known as Lou Gehrig’s Disease, you are automatically enrolled in Medicare the month your benefits begin.
- If you have end stage renal disease, you can contact the Social Security Administration to enroll in Medicare.
In general, if you are eligible for Medicare, you can choose to enroll in a Medicare Advantage plan, regardless of your health. People with end stage renal disease are the exception – you cannot enroll in most Medicare Advantage plans, but you may qualify for a different type of Medicare Advantage plan known as a special needs plan.
Your initial enrollment period for a Medicare Advantage plan begins three months before the month you are enrolled in Medicare, and it ends three months after the month your Medicare benefits begin. You can also enroll in or change Medicare Advantage plans during the annual election period, from October 15 to December 7.
Switching from Medicare Advantage to Medigap At Age 65
If you are disabled and are turning 65, you can switch from Medicare Advantage to Original Medicare and sign up for a Medicare Supplement during your open enrollment period – a six month window that begins on the first day of the month you turn 65.
If you sign up for a Medigap plan during this time, the insurance company must sell you a policy, and they can’t charge you extra money because of the condition that led to your disability, or any other health issues. If you wait, your policy will be medically underwritten, and your health situation could mean that you’ll be unable to get a policy at all.
Find Medicare Coverage for Disabilities
At MedicareFAQ, we know you need the best Medicare coverage possible to stay on top of your health. We can get quotes from top insurance companies for Medicare Advantage and Medicare Supplement insurance – with no obligation. Give us a call at the number above, or fill out our quote form.