How to Enroll in Medicare if You Are Under 65 and Have a Disability

By Brian Krantz - March 28, 2023

Medicare is a federal health insurance program that provides coverage for people who are 65 years of age or older, as well as for those who have certain disabilities. If you have a disability and are under 65 years of age, you may be eligible for Medicare coverage. Enrolling in Medicare can be a complex process, but it is important to understand the steps involved to ensure that you have access to the health care benefits you need. In this article, we will guide you through the process of enrolling in Medicare if you are under 65 and have a disability.

What is Medicare and Who is Eligible for Coverage?

Medicare is a federal health insurance program that provides coverage for people who are 65 years of age or older, as well as for those who have certain disabilities. Medicare covers a wide range of medical services, including hospital stays, doctor visits, prescription drugs, and more.

To be eligible for Medicare, you must meet certain requirements. If you are 65 years of age or older and a U.S. citizen or permanent legal resident, you are generally eligible for Medicare. However, if you are under 65 years of age, you may still be eligible for Medicare if you have a disability.

The Two Parts of Medicare

There are two main parts of Medicare: Part A and Part B. Part A provides coverage for hospital stays, skilled nursing facility care, hospice care, and some home health care. Part B provides coverage for doctor visits, outpatient care, and some preventive services.

In addition to Part A and Part B, there are also Medicare Advantage plans (Part C) and prescription drug plans (Part D). Medicare Advantage plans are offered by private insurance companies and provide coverage for all of the services covered by Part A and Part B, as well as additional benefits. Prescription drug plans provide coverage for prescription drugs.

Enrollment Periods for Medicare

There are several enrollment periods for Medicare, including the initial enrollment period, the general enrollment period, and the special enrollment period.

The initial enrollment period is a seven-month period that begins three months before your 65th birthday and ends three months after your birthday month. This is the time when most people enroll in Medicare for the first time.

The general enrollment period is from January 1 to March 31 each year. During this time, you can enroll in Medicare if you did not enroll during your initial enrollment period.

The special enrollment period is for people who experience certain life events, such as losing employer-sponsored health coverage or moving to a new state. This period allows you to enroll in Medicare outside of the other enrollment periods.

Enrolling in Medicare if You are Under 65 and Have a Disability 

If you are under 65 years of age and have a disability, you may be eligible for Medicare. There are several ways to qualify for Medicare based on a disability, including Social Security Disability Insurance (SSDI), Supplemental Security Income (SSI), End-Stage Renal Disease (ESRD), and Amyotrophic Lateral Sclerosis (ALS).

Social Security Disability Insurance (SSDI)

SSDI is a federal program that provides financial assistance to people with disabilities who are unable to work. If you have been receiving SSDI for at least 24 months, you will automatically be enrolled in Medicare. You will receive a Medicare card in the mail three months before your 25th month of disability benefits.

Supplemental Security Income (SSI)

SSI is a federal program that provides financial assistance to people with disabilities who have limited income and resources. If you receive SSI benefits, you will automatically be enrolled in Medicare Part A and Part B. You will receive a Medicare card in the mail three months before your 25th month of disability benefits.

End-Stage Renal Disease (ESRD)

ESRD is a medical condition in which your kidneys no longer function properly and you require regular dialysis or a kidney transplant. If you have ESRD, you may be eligible for Medicare regardless of your age. You can enroll in Medicare by contacting the Social Security Administration.

Amyotrophic Lateral Sclerosis (ALS)

ALS, also known as Lou Gehrig’s disease, is a progressive neurological disorder that affects nerve cells in the brain and spinal cord. If you have ALS, you will automatically be enrolled in Medicare as soon as your disability benefits begin.

How to Apply for Medicare

If you are eligible for Medicare based on a disability, you can apply for Medicare online, by phone, or in person.

Applying for Medicare Online

You can apply for Medicare online by visiting the Social Security Administration’s website. The online application process is easy and convenient, and you can complete it from the comfort of your own home.

Applying for Medicare by Phone

You can also apply for Medicare by phone by calling the Social Security Administration’s toll-free number. A representative will guide you through the application process and answer any questions you may have.

Applying for Medicare in Person

If you prefer to apply for Medicare in person, you can visit your local Social Security Administration office. A representative will assist you with the application process and provide you with any necessary forms and information.

What Happens After You Enroll in Medicare?

Once you enroll in Medicare, you will receive a red, white, and blue Medicare card in the mail. This card will show whether you have Medicare Part A, Part B, or both. If you have a Medicare Advantage plan or a prescription drug plan, you will also receive a separate card for each of these plans.

Once you have enrolled in Medicare, you can begin using your benefits to pay for medical services and supplies. It is important to understand what services are covered by Medicare and what costs you may be responsible for.

Enrolling in Medicare if you are under 65 and have a disability can be a complex process, but it is important to understand the steps involved to ensure that you have access to the health care benefits you need. There are several ways to qualify for Medicare based on a disability, including SSDI, SSI, ESRD, and ALS. You can apply for Medicare online, by phone, or in person. Once you have enrolled in Medicare, you can begin using your benefits to pay for medical services and supplies. You should always work with a local Medicare agent, like the experts at Plan Medicare, to ensure you are getting the proper coverage. 

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