How do i get medicare after 2 years of disability

Q: Does Social Security automatically enroll you in Medicare?

If you already get Social Security benefits, well automatically enroll you in Medicare Hospital Insurance (Part A) and Medical Insurance (Part B). Well mail you all the information you need a few months before you become eligible. Note: Residents of Puerto Rico or foreign countries wont automatically receive Part B.

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You have to wait two years after you are entitled to disability benefits to get Medicare unless you fit into an exception.
Free evaluation for disability benefits. Get up to $3,345 per month.
Free evaluation for disability benefits. Get up to $3,345 per month.
Answer a few questions to check your eligibility.
When Medicare Starts for Social Security Disability Recipients
Exceptions to the Two-Year Waiting Period for Medicare
Getting Medicaid While You Wait
Talk to a Disability Lawyer
Why do I have to wait 2 years for Medicare?
Does Medicare automatically come with disability?
Does Social Security automatically enroll you in Medicare?
Is Medicare retroactive with disability?

You have to wait two years after you are entitled to disability benefits to get Medicare unless you fit into an exception.

Free evaluation for disability benefits. Get up to $3,345 per month.

Answer a few questions to check your eligibility.

All Social Security disability insurance (SSDI) recipients can receive Medicare coverage two years after the first month they're eligible for their monthly disability benefits. But this doesn't mean that every individual who is approved for Social Security disability will have to wait two years for Medicare coverage, as we'll explain below.

In general, the two-year waiting period for Medicare is calculated from your date of SSDI entitlement—when you are eligible to start receiving monthly benefits. This is usually the date your disability began, plus five months (due to the five-month waiting period for SSDI). (For more information on calculating your date of entitlement, our article on disability onset and backpay.)

But if your disability onset date is far enough back, you may have already "served" much or all of the two-year waiting period by the time you get a favorable decision (approval of benefits) from Social Security. (For some claims that go through the appeal process to a hearing in front of an administrative law judge, it can take one to two years to get a disability decision.)

There's one caveat to this rule: your onset date for payment purposes can only be 17 months before your application date—that's because Social Security allows a maximum of 12 months of retroactive benefits. (This maximum gets you to 12 months before your application date, plus five months for the waiting period, so the earliest your effective onset date can be is 17 months before the application date.) In this case, the earliest that you can become eligible for Medicare is one year after you apply for Social Security disability.

On the other hand, for disability applicants who apply for benefits only when they become disabled, and not before, the date that their Medicare coverage will start is more likely to be two years and five months after they apply for disability.

Why the two-year waiting period for Medicare? Social Security has had this two-year waiting period in place since Medicare became part of the disability process. The waiting period was put in place as a cost-saving measure, so it's unlikely to change.

Exceptions to the Two-Year Waiting Period for Medicare

There are a couple of exceptions to the two-year wait for Medicare. If you suffer from one of the following medical conditions, you can receive expedited Medicare coverage sooner than normal:

End-stage renal disease (ESRD) with kidney failure. If you require ongoing dialysis or a kidney transplant, Medicare coverage can begin the third month after the month in which your dialysis began (whether or not you receive disability benefits).
Amyotrophic lateral sclerosis (ALS). Individuals with amyotrophic lateral sclerosis (ALS) qualify for Medicare as soon as they're eligible to receive disability benefit payments.

Learn more about the Medicare that comes with disability benefits.

Getting Medicaid While You Wait

Disability recipients with low income and low assets may qualify for the Medicaid program during the two-year waiting period for Medicare. Some states set their own rules regarding Medicaid eligibility, but those granted SSI at the same time as SSDI almost always qualify for Medicaid.

While Medicare covers hospice for those who are expected to pass within six months, the waiting period prevents many with a terminal illness from using Medicare for hospice needs. However, all 50 states' Medicaid programs cover hospice for those with low income and low assets. States may vary regarding the length of hospice coverage they provide and the amount of inpatient care that's covered.

Updated April 20, 2022

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A serious concern for those who have been approved for Social Security Disability benefits is medical coverage. Often, people lose their major medical coverage after they have been unable to work for an extended period of time. While COBRA (Consolidated Omnibus Budget Reconciliation Act of 1985) does allow many workers to continue their coverage, many cannot afford to pay the full insurance premiums.

If your Social Security Disability claim has been accepted, whether you receive SSDI or only SSI, you will qualify for Medicare after you have been eligible for Social Security Disability benefits for 24 months. You will be advised when your period of eligibility is approaching regarding how you should apply for Medicare.

All Social Security Disability beneficiaries are eligible for Part A (hospitalization) of Medicare and are required to enroll, even if you have other insurance coverage. Medicare Part A is provided at no cost for qualifying recipients. Failure to enroll in Medicare Part A when it is offered to you can result in you having to pay back Social Security Disability benefits, therefore making it necessary to sign up. In other words, while you are eligible to enroll in Medicare after 2 years, you are also required to.

If you do have other major medical coverage, Medicare will be your secondary insurer. Basically, this means that your primary insurance will pay what they would normally pay while Medicare covers any existing gaps in your coverage.

Medicare Plan B is also offered to Social Security Disability recipients. Medicare Part B covers doctor’s visits. If you accept part B, you will need to pay premiums based on your income level.

Those who have both Medicare Part A and Part B are eligible to participate in Medicare Part C, also known as Medicare Advantage Pans. There are a variety of Medicare Part C Advantage Plans available to those who receive Social Security Disability benefits. The plans are similar to other health insurance plans, offering pay for service, PPO, and managed care plans. They are typically sold by private-for-profit and non-profit insurance companies.

You will also be eligible to enroll in Medicare Part D, which covers prescription drugs. If you opt for this coverage, you are better off enrolling in Part D when you first enroll in Medicare, as there is a penalty for joining later.

You should be aware that signing up for the optional Medicare coverages does sometimes include waiting periods for pre-existing conditions, just as other insurance programs often do. Also, you should know that through the COBRA program, you can continue your Medicare coverage even if you lose your SSD benefits or return to work.

If you have not been contacted regarding enrollment in Medicare after you have been eligible for Social Security Disability benefits for 24 months, contact your Social Security Administration for more information . Remember that the 24 months are counted from your date of eligibility, not the date that you actually started receiving Social Security Disability payments. This means that you need to be aware of the actual date that you applied for your Social Security Disability benefits as well as the date that your disability began.

Your eligibility for Medicare is not affected by whether you are collecting SSDI or only SSI. If you have been approved for any Social Security Disability benefits due to your disability, you will be eligible for Medicare after you have been on Social Security Disability for two years. Depending on your income level, you may have to pay premiums for Medicare Parts B, C, and D. The amount you will need to pay is income based.

Why do I have to wait 2 years for Medicare?

The original purposes of the 24month waiting period were to limit costs to the Medicare trust funds at a time when many workers might have other health insurance coverage and to ensure that Medicare protection is extended only to persons whose disabilities are severe and long lasting.

Does Medicare automatically come with disability?

Will a beneficiary get Medicare coverage? Everyone eligible for Social Security Disability Insurance (SSDI) benefits is also eligible for Medicare after a 24-month qualifying period.

If you already get Social Security benefits, we'll automatically enroll you in Medicare Hospital Insurance (Part A) and Medical Insurance (Part B). We'll mail you all the information you need a few months before you become eligible. Note: Residents of Puerto Rico or foreign countries won't automatically receive Part B.

Is Medicare retroactive with disability?

You have to wait two years after you are entitled to disability benefits to get Medicare unless you fit into an exception. All Social Security disability insurance (SSDI) recipients can receive Medicare coverage two years after the first month they're eligible for their monthly disability benefits.