Are You on Medicare Due to Disability?

Social Security disability is a benefit for folks under 65 that provides assistance to people who meet Social Security requirements for disability.  When a person is awarded Social Security disability, he/she will be granted Medicare starting the 25th month of disability.

If your disability took a while to get approved and SSA backdates the effective date of your disability benefits, the months that have passed will count toward the Medicare qualification period.  For example, if you applied for disability in September of 2022 and were awarded disability in August of 2024 but it was backdated to September of 2023, September 2023 would be month 1.  Your Medicare would then start October 1, 2025.

There are a few exceptions to this rule.  If you have ALS, you’ll get Part A and Part B automatically the month your Social Security disability benefits begin.

If you have been diagnosed with End Stage Renal Disease (ESRD), and you want Medicare, you will need to sign up for it.  You can qualify for this coverage if you have permanent kidney failure requiring dialysis or a kidney transplant. When you sign up for Medicare based on ESRD and you’re on dialysis, Medicare coverage usually starts on the first day of the fourth month of your dialysis treatments.

If you have coverage through your employment or a spouse’s employment, there are two scenarios for how Medicare will work with the Employer Plan while on disability.  If the employer has 100 or more employees, the employer plan will be primary.  If there are fewer than 100 employees, then Medicare will pay primary to the employer plan.

If you were not working due to your disability and then go back to work, as long as your disabling condition still meets SSA’s rules, you can keep your Medicare coverage for at least 8 ½ years after you return to work.

As you can tell, there are a lot of different scenarios, and it can get overwhelming.  Please call me if you have any questions. 720-626-6524