Medicare & Disabilities

Medicare & Individuals with Disabilities

Although Medicare is often thought of as an insurance program for seniors, 16% of the benefits it provides are for people under age 65 with disabilities, i.e. 9.5 million people.

Medicare is automatically available for certain individuals with disabilities under age 65 who have received Social Security Disability benefits for 24 months or have End Stage Renal Disease (ESRD) or Amyotrophic Lateral Sclerosis (ALS, also known as Lou Gehrig’s disease). Individuals with ESRD and ALS do not have to serve a 24 month waiting period and will automatically receive Medicare Parts A and B the month their Social Security Disability benefits begin. If you have been on Social Security Disability for 24 months and have not received your Medicare notification, contact the CHOICES program for help to obtain your Medicare card.

If you are under 65 and receive Social Security Disability, and have group health-plan coverage based on your employment or a family member’s current employment, your group health-plan insurance pays first. However, being employed doesn’t disqualify an individual from receiving Medicare benefits. There are programs designed to assist individuals with disabilities to receive Medicare benefits even when the individual is participating in full employment.

The benefits provided to people with disabilities are the same as the benefit package provided to seniors and the premium costs and co-pays are the same.

You may be eligible to get help to pay your Medicare premiums if you have limited income. Some people are eligible for both Medicare and Medicaid. Dual eligible beneficiaries are generally enrolled in Medicare Part A and/or Part B and receiving full Medicaid benefits and/or assistance through a Medicare Savings Program (MSP) which helps pay premiums and co- pays.

If you are receiving Social Security Disability and are considering employment it would be wise to ensure you are complying with the regulations that protect your Medicare benefits. CT provides employment trial periods during which benefits are not in jeopardy. The Agencies on Aging have staff who can provide you with accurate, independent information about your options, at no cost to you.