How to Get Medicare Before Age 65 If You Have a Disability

Yes, you can get Medicare if you are disabled, even if you are under 65

Medicare is not limited to people over 65. If you have been receiving Social Security Disability Insurance (SSDI) for 24 months, you become covered by Medicare automatically. You do not need to wait until you turn 65. The 24-month waiting period starts from the month you first receive a disability payment, not from the month you applied.

There is one exception: if you have End-Stage Renal Disease (ESRD) — permanent kidney failure requiring dialysis or transplant — you can get Medicare right away, without waiting 24 months. The same applies if you have Amyotrophic Lateral Sclerosis (ALS), also called Lou Gehrig's disease; you become covered when ready upon approval for SSDI.

Once your 24-month waiting period ends, Medicare Part A (hospital insurance) and Part B (medical insurance) start automatically. You do not have to do anything to set up them. Your coverage begins on the first day of the month after your 24-month period ends.

Key Takeaways

You must first be approved for Social Security Disability Insurance (SSDI) through the Social Security Administration; Medicare follows after 24 months of receiving payments.
If you have End-Stage Renal Disease or ALS, Medicare begins when ready upon SSDI approval, with no waiting period.
Medicare Part A and Part B start automatically once you may have access to; you do not need to enroll separately.
You can still work and earn income while on SSDI and Medicare, as long as your earnings stay within Social Security's limits.
You will receive a Medicare card in the mail before your coverage begins, so you can share it with your doctors and hospitals.

How the 24-Month Waiting Period Works

The 24 months is measured from the first month you receive an SSDI payment, not from when you applied or were approved. If you were approved in March but your first payment arrived in April, your 24-month clock starts in April. After 24 months of payments, you are covered by Medicare on the first day of the 25th month.

You must continue to receive SSDI payments during this entire period. If your payments stop — for example, because your work income exceeded the limit — the clock may reset. Contact Social Security to confirm your timeline if your payments have been interrupted.

Social Security will send you a notice in the mail when your Medicare coverage is about to begin. This notice will tell you the exact date and explain what to expect. You will also receive your Medicare card before that date.

What Happens When You Turn 65

When you reach 65, your Medicare coverage does not change. You remain on the same Medicare Part A and Part B that you have had since your disability period. There is no gap, no new enrollment, and no interruption. Your coverage straightforward continues.

At 65, you may become may be able to access for other programs that were not available to you as a younger disabled person — such as certain Medicaid programs or prescription drug information programs — but your Medicare itself stays the same. If you have questions about what else might be available to you at 65, you can contact your state Medicaid office or call 1-800-MEDICARE to ask.

Getting SSDI Approved Is the First Step

Before Medicare can begin, you must first be approved for SSDI by the Social Security Administration. This is a separate process from Medicare. You explore through Social Security, not through Medicare.

To explore for SSDI, you can visit your local Social Security office, call 1-800-772-1213, or explore online at ssa.gov. You will need to provide medical evidence that your condition prevents you from working. The approval process can take several months, and many people are denied on their first process. If you are denied, you have the right to appeal.

Once you are approved for SSDI and have received 24 months of payments (or when ready if you have ESRD or ALS), Medicare begins automatically. You do not explore for Medicare separately when you have SSDI — it is built into the system.

What Medicare Covers for Disabled People

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 medical equipment. Together, they work the same way for disabled people as they do for people over 65.

You will have out-of-pocket costs — a deductible for Part A, a deductible and 20% coinsurance for Part B, and copays for some services. If your income is very low, you may be able to get help paying these costs through a program called Medicaid or a Medicare Savings Program. Each state runs these programs differently, so contact your state Medicaid office to learn what is available where you live.

Medicare does not cover dental, vision, or hearing care. Many people add a private plan — called a Medigap or Medicare Advantage plan — to cover gaps in Medicare. You can enroll in these plans during certain times of the year.

Working While on SSDI and Medicare

You can work and earn money while receiving SSDI and Medicare. Social Security has rules about how much you can earn before your payments are affected. For 2024, you can earn up to a certain amount per month without losing benefits; the exact limit changes each year. Once you earn above that limit, your benefits are reduced by $1 for every $2 you earn over the limit.

There is also a Trial Work Period that lets you test your ability to work for nine months without losing any benefits, no matter how much you earn. After the Trial Work Period ends, the earnings limit applies. This is a real opportunity to see whether you can return to work without when ready losing your safety net.

Your Medicare coverage does not stop if you work and your SSDI payments are reduced or end. Once you have been on SSDI for 24 months and Medicare begins, you can keep Medicare even if you go back to work full-time and your disability payments stop. This is called Extended Medicare Coverage, and it lasts for a set period depending on your situation.

What to Do When Your Medicare Coverage Begins

When your 24-month waiting period ends, Social Security will mail you a Medicare card. This card shows your Medicare number and which parts of Medicare you have (usually Part A and Part B). Keep this card with you and share the number with your doctors, hospitals, and pharmacies.

Before your coverage begins, you should choose a primary care doctor and make sure your current doctors accept Medicare. You can search for doctors on Medicare.gov. If you want to add prescription drug coverage (Part D), you must enroll during your initial enrollment period or you may face a penalty later.

If you have questions about your coverage or need help understanding your Medicare benefits, you can call 1-800-MEDICARE (1-800-633-4227) for free. They can answer questions about what is covered, help you find doctors, and explain your costs.

Frequently Asked Questions

Do I have to be on SSDI to get Medicare as a disabled person?

Yes. Medicare for disabled people under 65 is tied to SSDI approval. If you are disabled but not approved for SSDI, you cannot get Medicare through disability. You would have to wait until age 65 or find another way to pay for health insurance.

What if I was denied for SSDI? Can I still get Medicare?

Not through the disability route. However, you have the right to appeal a denial. Many people are approved on appeal or after reapplying. If you want to pursue this, you can contact Social Security or work with a disability advocate or lawyer who specializes in SSDI cases.

Does Medicare cover prescription drugs?

Medicare Part D covers prescription drugs, but you must enroll in a Part D plan. It is not automatic. You can enroll during your initial enrollment period (which starts three months before your Medicare begins) or during the annual enrollment period in the fall. If you miss these windows, you may pay a penalty.

Can I have both Medicare and Medicaid?

Yes. Many disabled people have both. Medicaid can help pay Medicare premiums and out-of-pocket costs. To learn whether you may have access to for Medicaid in your state, contact your state Medicaid office or call 211 for a referral to local resources.

What happens to my Medicare if I go back to work and my SSDI payments stop?

Your Medicare can continue for a period of time even after your SSDI payments end due to work. This is called Extended Medicare Coverage. The length depends on your situation, but it gives you time to transition. Contact Social Security to learn how long your coverage will last in your case.

This guide is for general information only and is not medical, financial, legal, or other professional advice. For decisions specific to your situation, consult a qualified professional. See our Editorial Policy.