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When does Medicare start with SSDI?

Social Security enrollment form
Just the essentials...
  • Usually, there is a two-year wait between SSDI benefits and the start of Medicare
  • Numerous factors can affect the waiting period
  • Circumstances can impact the availability of benefits

While Social Security and Medicare are linked together in the federal bureaucracy, there is often confusion about when benefits can be received.

SSDI stands for Social Security Disability Income and accordingly is administered under Social Security guidelines. Medicare, a federal health care program originated in 1965 for people 65 and older.

Over the more than 50 years that Medicare has been in existence, a number of things have changed. Coordinating the two programs for maximum benefits can be a challenge, but the steps are needed to prevent fraudulent claims.

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Medicare at 65 is not an Absolute

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In the most literal of terms, Medicare benefits begin at age 65. There are exceptions.

A person younger than age 65 can receive SSDI benefits because of some disability that prevents working at a regular job. Thus the person would have to wait two years after receiving SSDI payments before being eligible for Medicare assistance.

Sometimes this is not an issue for several reasons. If a family member has a disability but is covered by the family’s private insurance, that person could receive Medicare benefits as soon as he was no longer eligible under his parents’ health policy.

Special Circumstances

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There are at least two cases where people can receive Medicare benefits sooner according to Disability Secrets. They include:

  • End-stage renal disease with kidney failure: If a person requires ongoing dialysis or a kidney transplant, the Medicare coverage can begin the third month after the month when the dialysis started.
  • Amyotrophic lateral sclerosis (ALS), commonly known Lou Gehrig’s disease: Individuals with the condition will qualify for Medicare as soon as they are eligible to receive disability benefit payments.

Understanding What to Do

 

When it comes to drawing Medicare benefits, all you have to do is wait until you are nearing 65. Next, you will need to contact Security Office, answer some questions and your Medicare card will arrive in the mail.

The benefits will start on the first day of the month in which you turn 65.

However, seeking health care benefits before becoming eligible for Medicare as a result of age can be a little more involved.

When Will Benefits Begin?

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When discussing SSID benefits and Medicare benefits, it is usually about people who have not reached the age of 65 and developing a disability that has a sudden impact, such as being paralyzed, blinded or some other physical condition.

Timing is an important issue. A person disabled since birth will receive SSDI benefits. Depending on conditions, Medicare benefits may be authorized at an early age.

The issue of having a disability but are still able to work can have an impact on when benefits begin, how much you will receive, or if you are eligible.

Most Common Scenario

A person, who has a benefit that qualifies for SSDI, will usually have to wait two years before receiving Medicare benefits.

There are various nuances that have to consider. For example, if the disability is the result of an accident or sudden illness, the two-year waiting period will apply. However, if the disability has existed for an extended period the waiting period may be waived or reduced.

When Early Medicare Coverage is Available

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Medicare is available to everyone age 65 or older. However, a person can be over 18 and under 65 and receive Medicare benefits if one of the following conditions applies:

  • You have received Social Security disability benefits, or SSDI, for at least two years.
  • You have been diagnosed with Lou Gehrig’s Disease, also called Amyotrophic Lateral Sclerosis (ALS), and are starting to get Social Security disability.
  • Usually, you can get Medicare the sixth month after Social Security found that your disability started.
  • You have been diagnosed with end-stage renal disease, sometimes called ESRD, and have been on dialysis for three months or have had a kidney transplant.

Securing the Benefits

If a person has a disability that is not immediately noticeable, securing benefits may take longer. There no option that lets you go to the Social Security Office to apply and then wait for the check.

Documentation will have to be provided by you and your doctors. You may also be required to have examinations by doctors in your area but are selected by the Social Security Administration.

Conclusion

Social Security Disability Income, Medicare, and other benefits are available to the elderly, the injured and those with disabilities, regardless of age.

However, there is no one answer applies to all people. The more severe diseases, such as ALS move through the system quicker than others. Having the disability for an extended prior to applying for assistance may shorten the process.

Do not assume that you will not qualify for benefits because someone you know was turned down. While there are basic rules, every person is unique.

Do not look for the assistance as charity. Social Security and Medicare were both originally designed to help the elderly. Over the years, the scope of the two programs has expanded to help all people in need.

Finally, be patient when seeking benefits. The application process may seem like a bureaucratic maze, but making sure that the programs are administered to help those in need require a certain amount of diligence by the Social Security Administration and other federal agencies.

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MedicareInsurance.com is privately owned and operated. MedicareInsurance.com is a non-government asset for people on Medicare, providing resources in easy to understand format. The government Medicare site is www.medicare.gov.

This website and its contents are for informational purposes only and should not be a substitute for experienced medical advice. We recommend consulting with your medical provider regarding diagnosis or treatment, including choices about changes to medication, treatments, diets, daily routines, or exercise.

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MULTIPLAN_GHHK5LLEN_Accepted Last Updated 3/18/2018