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How Social Security Disability Benefits And Medicare Are Related


If you become disabled due to an illness or injury and cannot work, you may be able to receive Social Security Disability Insurance (SSDI) benefits. These benefits allow you to receive monthly benefits and while they can be helpful in paying some bills, they do not replace your income.

If you do receive SSDI benefits, you may wonder about how you will pay for medical care. You won’t be able to get insurance through your job like many Americans do, since you likely won’t be employed. And buying insurance on your own can be pricey, so what can you do?

If you receive SSDI benefits, you automatically qualify for Medicare. However, Medicare and Social Security are two separate entities, so you likely won’t receive Medicare right away unless you’re old enough. Medicare is primarily available to seniors age 65 and older. Some people can also qualify at a younger age, though, if they have a disability.

But there is a waiting period involved. Most SSDI recipients qualify for Medicare after they receive disability benefits for 24 months.Those with amyotrophic lateral sclerosis (ALS) or end-stage renal disease will have the waiting period waived.

The waiting period has been in place since 1972. The reason for the two-year delay was to help mitigate the cost of adding beneficiaries to Medicare. It was also done to avoid replacing coverage some disabled workers would be able to get from their former employers through COBRA. It didn’t make sense to offer Medicare if beneficiaries could still get healthcare insurance through an employer.

But keep in mind that by the time you receive Medicare, it could actually be 29 months from the time you become eligible for SSDI benefits. That’s because there is also a waiting period for SSDI payments. Once the Social Security Administration determines you are eligible for SSDI payments, there is a waiting period that lasts five calendar months.

It is possible to get Medicare while you wait, though. You can do one of the following:

  • Apply directly to your state Medicaid agency.
  • Complete a Medicaid application. Answer “yes” when asked if you have a disability. Your application will be sent to your state Medicaid agency.

Also, note that if you have both SSDI and Medicare, you are considered covered under the healthcare law. This means you will not be able to  enroll in an Obamacare Marketplace plan to replace or supplement your Medicare coverage as long as you are receiving SSDI benefits.

Learn More About Social Security Disability Benefits

If you get SSDI benefits, you qualify for Medicare as well. However, there is a waiting period as well as other laws involved, so make sure you understand what to expect.

Disabled and unable to work? If so, a White Plains Social Security Disability lawyer from The Law Office of Michael Lawrence Varon can ensure you receive all the benefits you are entitled to receive. We understand all the nuances of the law. To schedule a free consultation with our office, call (914) 228-1770 or fill out the online form.



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