Understanding Social Security Disability and Medicare Benefits

You can’t work because of a serious injury or illness. You may be worried not only about your lost income, but also about the prohibitively high cost of health insurance. If you are eligible for Social Security disability, it is important to know whether you may also be eligible for Medicare and how Medicare may help you.

Medicare Enrollment FormAre You Eligible for Medicare?

According to the Center for Medicare and Medicaid Services (CMS), most Social Security disability recipients are eligible for Medicare after they have been receiving Social Security disability benefits for 24 months. Thus, after the waiting period for Social Security benefits, the soonest that a Social Security disability recipient may receive benefits is in the 30th month after becoming disabled.

There is one important exception, however. In 2001, a change was made for Social Security disability recipients with Amyotrophic Lateral Sclerosis (ALS), also known as Lou Gehrig’s disease. Social Security disability recipients with this medical condition do not have to wait the 24 months for Medicare and may be eligible the first month they receive Social Security disability.

If you are eligible for Medicare, your benefits should be automatic and you should not have to take any action unless you want to change your coverage.

What Is Medicare Coverage?

Medicare coverage includes four parts:

  • Part A: Hospital insurance. Part A helps to pay for hospital bills and some follow-up medical care. There are no premiums paid for Part A, since the coverage is financed by taxes paid while working.
  • Part B: Medical insurance. Part B helps to pay for doctors’ bills and other services. Social Security disability recipients can opt out of this coverage, thereby avoiding the need to pay monthly premiums. This may be important if you have other medical coverage
  • Part C: Medicare Advantage. Part C is managed by private insurance companies approved by Medicare. Each Part C plan combines the benefits of Parts A and B, but the costs, deductibles, and other details may differ.
  • Part D: Prescription drug coverage. Part D covers medications that doctors prescribe for treatment. Anyone who has Part A, Part B, or Part C is eligible for Part D.

Medicare can be an important benefit for Social Security disability recipients. Accordingly, we encourage you to share this article on Facebook or directly with a loved one who may benefit from this information.  If you or a loved one has any questions, please reach out to us directly to get the answers you deserve.

Carl M. Weisbrod
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Managing Partner of Morgan & Weisbrod, Board Certified in Social Security Disability Law