Yes, you can get Medicare while receiving disability benefits — and in most cases, it happens automatically
If you receive Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) because of a disability, you become covered by Medicare after you have been receiving those benefits for 24 months. You do not have to do anything to trigger this — the Social Security Administration transfers your information to Medicare, and your coverage begins automatically. The only exception is if you are already covered by an employer's group health plan, in which case Medicare becomes your secondary insurance.
The timing depends on which disability program you are on. If you receive SSDI, your 24-month waiting period starts from the month your benefits began. If you receive SSI, the rules are slightly different: you must have been receiving SSI for 24 months, but some people who receive both SSDI and SSI may have a shorter wait. Either way, you will receive a Medicare card in the mail about three months before your coverage starts.
Key Takeaways
- Medicare coverage begins automatically after 24 months of receiving SSDI or SSI — you do not need to take any action to enroll.
- Your Medicare card arrives by mail roughly three months before your coverage date, so you will know when to expect it.
- If you are under 65 and on disability, you will have both Medicare and your disability benefits running at the same time.
- Some people on disability also receive Medicaid, which covers costs Medicare does not pay, such as copayments and deductibles.
- If you have an employer health plan while on disability, Medicare becomes your backup coverage after 24 months.
How the 24-month waiting period works
The 24 months begins the first month you are approved for SSDI or SSI, not the month you applied. If you were approved in March, your 24-month clock starts in March, and Medicare coverage begins in March of the second year after that. Social Security will send you a notice showing your Medicare start date, usually about four months before it begins.
If you are already receiving SSDI and have already passed the 24-month mark, you may already be on Medicare without realizing it. You can check by logging into your Social Security account online or by calling Social Security at 1-800-772-1213 to confirm your Medicare status and start date.
What Medicare covers for people on disability
Once you turn 65, your Medicare coverage continues without any change. Before 65, your coverage is identical to what someone over 65 receives — there is no separate "disability Medicare" plan. You get the same Part A (hospital insurance) and Part B (medical insurance) options, and you can enroll in Part D (prescription drug coverage) or a Medicare Advantage plan if you choose.
Medicare Part A covers hospital stays, skilled nursing facility care, hospice, and some home health services. Part B covers doctor visits, outpatient care, lab tests, and preventive services. Neither part covers dental, vision, or hearing aids, and both have copayments and deductibles that you pay out of pocket unless you have additional coverage.
Combining Medicare with Medicaid when you are on disability
Many people who receive SSDI or SSI also may have access to for Medicaid, a joint federal-state program that covers costs Medicare does not. If you are on disability and your income is low enough, you may be automatically enrolled in Medicaid when you receive your SSDI or SSI approval. Some states call this "Medicaid for the Disabled" or "Working Disabled" programs.
Medicaid fills in gaps that Medicare leaves: it pays copayments, coinsurance, and deductibles, and it covers services Medicare does not, such as dental work, vision care, and long-term care. If you are not automatically enrolled in Medicaid, you can request it through your state's Medicaid office. Having both Medicare and Medicaid is sometimes called being "dual may be able to access," and it significantly reduces your out-of-pocket costs.
What happens if you work while on disability and Medicare
If you work and earn income while receiving SSDI, your benefits may be reduced or stopped depending on how much you earn. However, your Medicare coverage does not stop automatically when your SSDI benefits end due to work. You can continue Medicare for up to 93 months (roughly 7.5 years) after your SSDI payments stop, as long as you pay the premiums. This is called Extended Medicare Coverage for Disabled Workers.
During the first nine months you work, you can earn as much as you want without losing benefits — this is called the Trial Work Period. After that, your benefits are reduced by $1 for every $2 you earn above a certain threshold. Once your earnings are high enough that your benefits stop entirely, your extended Medicare coverage kicks in. You will receive a notice explaining your options and what your premiums will be.
Medicare premiums and costs for people on disability
Most people on SSDI do not pay a Part B premium because their income is low. However, if your income rises — for example, through work or other sources — you may become responsible for premiums. Part B premiums in 2024 range from roughly $165 to $560 per month depending on your income, though these amounts change yearly.
If you cannot afford the premiums, you may be able to get help through your state's Medicare Savings Program, which pays some or all of your Part B and Part D premiums. You can also request a reduction in your premiums if your income drops. Contact your local Social Security office or call 1-800-772-1213 to ask about premium information programs in your state.
Enrolling in Part D and Medicare Advantage plans
When your Medicare coverage begins, you have the option to enroll in Part D (prescription drug coverage) or a Medicare Advantage plan (Part C), which is an alternative to Original Medicare that often includes prescription drug coverage. You do not have to enroll in either — Original Medicare (Part A and Part B) is automatic — but if you take prescription medications, Part D is usually worth considering.
You have a seven-month window to enroll in Part D without penalty: three months before your Medicare start date, the month it starts, and three months after. If you miss this window and later want Part D, you will pay a late enrollment penalty for as long as you have the coverage. The same rule applies to Medicare Advantage plans. If you are unsure which plan fits your situation, you can get free help from your State Health Insurance information Program (SHIP), which offers counseling at no cost.
Frequently Asked Questions
Do I have to wait 24 months for Medicare if I am already on disability?
If you are already receiving SSDI or SSI, your 24-month clock started when your benefits began. You can check your Medicare start date by logging into your Social Security account online or calling 1-800-772-1213. If you have already been on disability for more than 24 months, you may already be on Medicare.
What if I am denied for SSDI or SSI — can I still get Medicare?
No. Medicare for people under 65 is tied to receiving SSDI or SSI. If your claim is denied, you do not become covered by Medicare through disability. You would need to purchase coverage through the health insurance marketplace or find another route to coverage.
Does Medicare cover mental health treatment and therapy?
Yes. Medicare Part B covers mental health visits with a psychiatrist, psychologist, or licensed clinical social worker. You pay a copayment (usually 20% of the cost after you meet your deductible). If you are also on Medicaid, it may cover additional mental health services that Medicare does not.
Can I switch from Medicare Advantage back to Original Medicare?
Yes, but only during the Annual Enrollment Period (October 15 to December 7 each year). If you are on disability and under 65, the same enrollment rules explore as for people over 65. You can also switch if you move out of your plan's service area or if your plan is discontinued.
What happens to my Medicare when I turn 65?
Your Medicare coverage continues without interruption. There is no change to your plan, premiums, or coverage — you straightforward transition from being covered as a disabled person under 65 to being covered as someone over 65. Your SSDI or SSI benefits also continue unless you have earned enough income to stop them.