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Medicare for Disabled Under 65

Medicare is available for everyone at any age.

Yes, you read that right!

However, you would not wish you’ll qualify for Medicare coverage while you are still under 65.



Because it is required that you are disabled or have a debilitating disease, such as End Stage Renal Disease (ESRD), to qualify for Medicare at an early age.


Currently, Medicare covers about 5 million people who are under 65 and disabled. The population is expected to grow and reach 9 million by 2020. That’s how much-disabled people America have.

Illustration for article titled Medicare for Disabled Under 65

What is Disability?

Disability is an impairment that hinders a person’s movements, senses or activities. It is a condition that affects the life of a person significantly.


Social Security Administration (SSA) has its own definition of disability and standards that should be met to qualify for Social Security benefits. The List of Impairments contains the medical criteria that are used to evaluate impairments in adults age 18 and above and to impairments of children 18 years old and below.

To be declared as disabled, you must:

· be unable to do any significant work because of a medical condition

· have the medical condition for at least a year. Medical condition that is most likely to cause your death is also a qualifying reason.


Eligibility for Medicare Disability Benefits for People Under 65

People who are qualified for Social Security Disability benefits are also qualified to have Medicare for disabled under age 65.


You don’t need to sign up for Medicare. You will be automatically enrolled in Part A and Part B of Medicare when you meet one of these:

· Received Social Security disability benefits for 2 years (24 months)

· Certain disability benefits from the RRB for 2 years (24 months)

You’ll receive your red, white and blue card in the mail when you have reached the required time period. It will usually arrive 3 months before your 25th month on disability. If it didn’t arrive at the expected time, you may contact your local Social Security office.


You can also apply for a Prescription Drug plan or Part D or opt your coverage as a Medicare Advantage plan.

What are the benefits of Medicare Disability coverage?

`Medicare benefits for the disabled beneficiaries are the same with Medicare coverage for those who qualify because of age.


Medicare Part A covers your hospital or inpatient needs while Medicare Part B covers your outpatient or medical needs. The health care services do not necessarily have to be related to the individual’s disability in order to be covered.

Medigap for disabled and under 65

Medigap insurance for disabled people under 65 is quite limited. Federal law does not require Medigap insurance companies to sell policies to people under 65 Medicare beneficiaries. But some states require to sell at least one type of plan to them. Medigap is a type of health insurance that works with Original Medicare. It works by reducing the out-of-pocket costs after Medicare has paid its share.


Medigap can be quite pricey when bought at an early age due to disability. That is because people with disability are expected to incur lots of medical expenses that yield high policy claims. Because private insurance company sells Medicare supplement policy, they can ask for a high premium to compensate with high claim ratio.

However, when people with disability turn 65, they can choose any type of Medicare supplemental plan just like any other applicants. That is because they will also have a Medigap Open Enrollment period which gives them the opportunity to enroll in policy without the need to undergo Medical underwriting. Also, insurers can’t reject or decline their application due to disability or any medical condition they have.


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