Qualifying For Medicare With Disabilities

Individuals with disabilities have historically had difficulty finding affordable health insurance due to their health issues. But Medicare helps by covering three categories of disabled people:

• Have received Social Security disability payments for no less than two years
• Have long term kidney failure
• Have Lou Gehrig’s disease

If you want a complete walkthrough of Medicare parts, eligibility, and enrollment windows, see our Medicare Guide.

How does the twenty-four-month waiting period work?

Usually, Medicare coverage begins on the first day of the 25th month of receiving SSDI payments. That 25th month counts as the fourth month of your seven-month initial enrollment period.

If you’d like to model how a waiting period could affect your finances, try our Retirement Calculator.

Exactly how long does Medicare coverage last?

If you qualify for Medicare through disability, your benefits continue for as long as you receive SSDI payments and possibly longer. If you lose SSDI due to returning to work, Medicare may continue for an additional ninety-three months under certain earnings limits.

If you are still receiving Medicare when you turn sixty-five, coverage continues seamlessly and transitions to age-based eligibility. You will receive a new seven-month initial enrollment period, allowing you to:

• Shop for better Medigap supplemental insurance options
• Change coverage choices and address late enrollment penalties

Also consider our Retirement Planning Checklist .

Living with Lou Gehrig’s disease

ALS, often called Lou Gehrig’s disease, is a degenerative condition affecting nerve cells in the brain and spinal cord. Individuals diagnosed with ALS qualify for Medicare once approved for Social Security or railroad retirement disability benefits.

Those receiving railroad retirement disability may qualify differently depending on whether the disability is total or occupational.

Health care options if you cannot get Medicare yet

• You are under sixty-five and must wait up to two years after qualifying for disability.
• You are sixty-five or older but do not meet residency requirements.
• You are losing employer coverage due to retirement.

Landing a job with benefits

Employer coverage is often the most stable option. Employers must offer equal coverage regardless of age, health status, or preexisting conditions.

Paying for temporary COBRA insurance

COBRA allows individuals to continue employer coverage for up to eighteen months by paying full premiums. This can be costly but may bridge gaps before Medicare eligibility.

Review additional protection options in our Life Insurance Buyer’s Guide .

Purchasing individual insurance through the Marketplace

The Marketplace allows individuals to purchase private health insurance regardless of health status. Financial hardship exemptions may apply depending on income and circumstances.

Purchasing insurance outside the Marketplace

You may also explore individual policies directly through insurers depending on availability and pricing.

Obtaining health care with no insurance

Community clinics and sliding-scale providers may offer reduced-cost care based on income if insurance is not available.

This Medicare resource was provided by Amerus Insurance Group, a nationwide independent agency that helps seniors confidently compare plan options, control out-of-pocket costs, and enroll with the right coverage for their doctors, prescriptions, and lifestyle. Whether you’re new to Medicare or reviewing your current plan, speak with an Amerus advisor for a free, personalized consultation.