How to Get Medicare When You're on Social Security Disability

You can get Medicare while receiving Social Security Disability Insurance, but you have to wait 24 months after your disability benefits start

If you are approved for Social Security Disability Insurance (SSDI), Medicare coverage does not begin right away. You become covered under Medicare automatically after you have been receiving SSDI payments for 24 consecutive months. This two-year waiting period is set by federal law and applies to nearly everyone on disability, regardless of age.

The 24 months are counted from the month your disability benefits actually begin, not from the month you applied. If Social Security approves your claim retroactively — meaning they say your disability started several months before you applied — those earlier months count toward your 24-month wait. Once you reach 24 months, Medicare Part A (hospital insurance) and Part B (medical insurance) start automatically on the first day of the month you become may be able to access.

There is one exception: if you are already 65 or older when you are approved for SSDI, you become covered under Medicare when ready instead of waiting 24 months. This is because you would be covered by Medicare anyway once you turn 65.

Key Takeaways

You must wait 24 months after your SSDI payments begin before Medicare coverage starts, even if you are younger than 65.
The 24-month clock includes any retroactive months that Social Security awards you, so your wait may be shorter than you think.
Medicare Part A and Part B start automatically once you reach 24 months; you do not have to contact Medicare or pay a separate enrollment fee.
If you are already 65 or older when approved for SSDI, you get Medicare right away without waiting.
During the 24-month wait, you may be able to purchase coverage through the health insurance marketplace or Medicaid, depending on your state and income.

What happens during the 24-month waiting period

While you wait for Medicare to begin, you are responsible for finding your own health coverage. Social Security Disability Insurance provides the cash benefit — the monthly payment — but it does not include health insurance during those first 24 months.

Many people on SSDI during the waiting period turn to Medicaid, which is a joint federal and state program that covers low-income individuals. Medicaid rules vary significantly by state. Some states cover working-age adults on disability automatically; others have income or asset limits that may disqualify you even though your SSDI payment is small. Contact your state Medicaid office or call 211 to learn what your state offers.

Another option is the health insurance marketplace (also called the Affordable Care Act marketplace). You can enroll during the annual open enrollment period (usually November through January) or if you experience a may have access to life event, such as losing other coverage. If your SSDI income is low, you may be able to receive tax credits that reduce your monthly premium.

How to track your 24-month countdown

Social Security sends you a notice when your disability claim is approved. This notice states the month your benefits begin — this is the month your 24-month clock starts. Keep this notice in a safe place, because you will need it to verify your may be able to access date if there are any questions later.

You can also check your benefit start date by logging into your my Social Security account at ssa.gov. Under "Benefit Information," you will see the month and year your SSDI began. Count forward 24 months from that date to find your Medicare start month.

About three months before you reach 24 months, Social Security will send you information about Medicare enrollment. You do not need to do anything — Medicare Part A and Part B will start automatically. However, you should review the information to understand your coverage and decide whether you want to enroll in a Medicare Advantage plan or a Medigap supplemental policy.

What to do if you turn 65 before reaching 24 months on SSDI

If you turn 65 while still waiting for your 24-month SSDI period to end, your Medicare coverage will start on the first day of the month you turn 65. You do not have to wait the remaining months. Social Security will automatically switch your disability claim to a retirement claim at age 65, but your monthly payment amount stays the same.

You will receive a notice from Social Security explaining this change. Your Medicare coverage begins automatically, just as it would for anyone turning 65. You should still review your coverage options and decide whether to enroll in additional plans.

Medicare coverage for people on SSDI with end-stage renal disease or ALS

Two groups of people on SSDI can get Medicare before the 24-month waiting period ends. If you have end-stage renal disease (ESRD) — permanent kidney failure requiring dialysis or transplant — you become covered under Medicare after three months of dialysis or when you receive a kidney transplant, whichever comes first.

If you have amyotrophic lateral sclerosis (ALS), also called Lou Gehrig's disease, you become covered under Medicare when ready when your SSDI claim is approved, with no waiting period at all.

If either of these conditions applies to you, Social Security will notify you of your Medicare start date. You should still verify the date in your my Social Security account to make sure the information is correct.

What Medicare covers once you are enrolled

Medicare Part A covers hospital stays, skilled nursing facility care, hospice, and some home health services. Medicare Part B covers doctor visits, outpatient care, medical equipment, and preventive services. Both parts have deductibles and copayments that you will be responsible for.

Medicare does not cover everything — dental, vision, hearing aids, and long-term custodial care are not included. Many people on SSDI choose to enroll in a Medicare Advantage plan (Part C), which is an alternative to Original Medicare that often includes dental and vision coverage. Others purchase a Medigap supplemental policy to help pay the costs that Medicare does not cover.

When your Medicare coverage is about to start, you will receive information from Social Security and Medicare explaining your options. You have time to review and decide which coverage works best for your situation.

Questions to ask your doctor or Social Security

Before your Medicare coverage begins, it can help to discuss your options with your healthcare provider. Ask whether they accept Medicare and what your out-of-pocket costs might be under different plans. If you are considering a Medicare Advantage plan, ask whether your current doctors are in the plan's network.

You can also contact Social Security directly with questions about your specific situation. Call 1-800-772-1213 (TTY 1-800-325-0778) or visit your local Social Security office. Have your Social Security number and your approval notice ready when you call.

Frequently Asked Questions

Does the 24-month wait start over if I stop receiving SSDI and then reapply?

No. If you are approved for SSDI again after a break in benefits, the new approval date becomes your new starting point for the 24-month countdown. However, if you return to work and your benefits are suspended (not terminated), the months you were suspended do not count toward your 24 months — only months when you actually received a payment count.

What if Social Security says I was disabled before I applied — do those months count?

Yes. Social Security sometimes approves claims with a retroactive onset date, meaning they determine your disability began months before you filed. Those retroactive months count toward your 24-month wait. For example, if you applied in June but Social Security says you were disabled starting in January, your 24-month clock started in January, not June.

Can I get Medicare before 24 months if I have a serious health condition?

Not because of a serious health condition alone. The only exceptions are end-stage renal disease (three months of dialysis or transplant) and ALS (when ready coverage). If you have another serious condition, you will need to wait the full 24 months or find other coverage during the waiting period.

What happens to my Medicare if I go back to work?

Once you have been on Medicare for 24 months, you keep it even if you return to work and your SSDI benefits stop. You will continue to pay your Medicare premiums, but your coverage does not end. If you return to work before 24 months, you lose Medicare when your SSDI benefits end, unless you are 65 or older.

Do I have to pay for Medicare Part B once I am on SSDI?

Yes. Medicare Part B has a monthly premium, which is usually deducted from your SSDI payment. Part A (hospital insurance) is free for people on SSDI. The Part B premium amount changes each year and depends on your income from the previous two years.

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.