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Medicare Disability Qualifications-MarketWatch


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Paying for medical expenses is a major concern when you have a disability. Fortunately, people who are eligible for rail or social security disability allowances are also eligible for Medicare disability. Here’s what you need to know to get Medicare disability compensation:

If you are paid for by Social Security Disability Insurance (SSDI) or Rail Disability, you are eligible for Medicare Disability. Eligible dates depend on the reason for the disabled.

In most cases, you will be eligible for a Medicare disability two years after you are eligible for SSDI or rail disability payments. For end-stage renal disease (ESRD) or amyotrophic lateral sclerosis (ALS or Lugeric’s disease), the 2-year waiting period does not apply.

If you qualify for Medicare Disability

Cause of failure

When qualified for Medicare Disability

Amyotrophic lateral sclerosis (ALS)

As soon as you start collecting disability allowances

End-stage kidney disease

3 months after receiving a kidney transplant or starting regular dialysis treatment

All other illnesses and conditions

24 months after qualifying for disability allowance

Retroactive benefits and disability waiting period

For most people, the Medicare eligibility date is 24 months after the date of eligibility for the disability allowance. The good news is that you may not have to wait two years after receiving your first benefit check. This is because the disability waiting period and retroactive benefit period can affect the date of compensation.

Must be required 5 months waiting period for disability allowance If you qualify for benefits. For example, if you are subject to a disability on August 1, 2020, your first payment will be made in January 2021, five months later.

Social security also allows people to stand up 12 months retroactive benefit.. This is because the application, qualification, and appeal process can take several months to complete. The waiting period and retroactive payment period may affect the effective date of Medicare.

Example: Jerry was injured at work in March 2019. After several months of failure in treatment, his doctor determined that his injury would lead to disability.

Jerry applied for SSDI in September 2019 and the application was approved in March 2020. Due to the waiting period, the date of eligibility for benefits was August 2019, five months after the date of the failure.

In April 2020, Jerry received her first benefit check. This included retroactive benefits dating back to August 2019, the date of qualification. He is eligible for Medicare Disability in September 2021, 25 months after the date of qualification. Jerry receives a Medicare allowance 17 months after receiving her first disability allowance.

How to register for Medicare Disability

In most cases you don’t need to do anything Register for Medicare.. As soon as you qualify, you will be automatically enrolled in Part A and Part B... Medicare will send you a “Welcome to Medicare” kit and ID card about 3 months before your coverage is valid.

Part B Premium ($ 144.60 in 2020) will be automatically deducted from SSDI or rail disability payments.

Enrollment in Part D with Medicare Disabilities

Not automatically registered in Part D..If you need prescription drug compensation, you need to purchase a plan during the period Initial registration period, It will be extended for 6 months from the effective date of Medicare. As soon as you get your Medicare ID, Part D plan In your area Medicare plan finder..

If you are taking medication daily, be sure to fill in the screening tools.By doing so you will be able to see how much you will be Payment of each prescription drug Then find the most cost-effective coverage.

If you choose Medicare Advantage, Part D is usually included in your plan.

Register for Medicare Advantage

Anyone who is eligible for Medicare Medicare Advantage Plan.. Once you have your Medicare ID card and effective date, you can apply for a plan sold in your area.

If you choose Medicare Advantage, you may need to pay the insurance company a separate premium in addition to the Part B premium. Most people have access to a $ 0 premium and a $ 0 deductible Medicare Advantage plan.

If you’re worried about the out-of-pocket costs of your original Medicare Medicare Advantage Plan It may be a good option. All Medicare Advantage plans have an annual out-of-pocket limit.. This means that the insurance company will pay 100% of the cost when the plan limit is reached.

The government’s highest amount in 2020 is $ 6,700, The average out-of-pocket cost of the Medicare Advantage Plan is approximately $ 4,900...

Some people with disabilities are eligible for the Medicare Advantage Special Assistance Plan (SNP). These plans always include Part D coverage. The premium is usually $ 0 and the deduction is $ 0, which includes additional benefits such as dental, vision, and care adjustments to help you manage your condition. The benefits are specially tuned to keep costs low.

Related: Find out if you have a Medicare Advantage plan in your area.

If I have a Medicare disability, can I get a Medicare supplement plan?

Under federal law, insurance companies do not have to sell Medicare supplement plan For people under 65 years old. If you qualify for Medicare Disability before you turn 65, you may not be able to purchase Medigap.

Fortunately, 33 states now have laws that require insurers to sell at least one of their standardized Medicare supplement plans to people under the age of 65 who are enrolled in Medicare. This means that if a company sells a Medigap plan in the state, it must offer at least one type of plan to people under the age of 65 with a Medicare disability.

People who have a Medicare disorder due to ESRD may not be able to purchase a Medicare supplement plan.. Not all states that insurance companies require to sell Medigap to people under the age of 65 extend their protection to people in ESRD. For this reason, if you have an ESRD, it’s a good idea to check how the law affects your state insurance department.

Related: Find the Medicare supplement plan option that’s right for you here.

States that insurance companies require people under the age of 65 to sell Medigap



New jersey



New York



North Carolina












South dakota











New Hampshire


If I have a Medicare Disability, when is the Medigap open registration period?

There is only one Medigap Open registration period.. It starts with the month you are 65 years old (or older) and enrolled in Part B.

If you obtained Medicare before the age of 65 Medicare supplement planHowever, coverage is not guaranteed. If you live in any of the above states, you can buy at least one plan, Insurance companies can charge you much higher premiums. Also, you may not get the type of coverage you want.

At age 65, issuance is guaranteed during the Medigap Open Enrollment period. This means you can buy plans for sale in your state and you can’t claim high premiums for your disability.

If you’re worried about your medical budget and can’t get a Medicare supplement plan until you’re 65, Medicare Advantage Plan It may be a good option for you.


Medicare is a lifeline for people with disabilities who are worried about medical expenses. If your Medicare Advantage plan better meets your needs, you are not tied to the original Medicare. Many people with disabilities are eligible for a low-cost special needs plan with additional benefits and services that help them manage their condition.

If you’re interested in a Medicare supplement plan, talk to your disability allowance coordinator or your state insurance department to find out how state law affects your eligibility.You can also talk to a Medicare professional certified by 844-259-6504 To help you understand your options and Choose the best coverage To suit your unique needs.


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