Insurance Read Time: 3 min

Qualifying For Medicare Under Age 65

When you are under 65, you become eligible for Medicare if:

  1. You have received Social Security Disability Insurance (SSDI) checks for at least 24 months
  2. Or, you have been diagnosed with End-Stage Renal Disease (ESRD)

Eligibility for Medicare due to a disability

You may qualify for Medicare due to a disability if you have been receiving SSDI checks for more than 24 months, also known as the two-year waiting period. The two-year waiting period begins the first month you receive an SSDI check. You will be automatically enrolled in Medicare at the beginning of the 25th month that you receive an SSDI check.

If you receive SSDI because you have Amyotrophic Lateral Sclerosis, or ALS, Medicare automatically begins the first month that your SSDI benefits start. You do not have the two-year waiting period.

Social Security—not Medicare—makes the determination of whether you qualify for SSDI checks and administers the program that provides the checks. For more information on the Social Security Disability Insurance program, it is recommended that you contact your local Social Security Administration (SSA) office.

Note: Railroad workers should contact the Railroad Retirement Board for information about disability annuity and Medicare eligibility.

Eligibility for ESRD Medicare

You may qualify for ESRD Medicare if you have been diagnosed with kidney failure and you:

  • Are getting dialysis treatments or have had a kidney transplant
  • And:
    • You are eligible to receive SSDI
    • You are eligible to receive Railroad Retirement benefits
    • Or, you, a spouse, or a parent have paid Medicare taxes for a sufficient amount of time as specified by the Social Security Administration

If you are under 65 and have ESRD, when your Medicare benefits begin depends on your specific circumstances, including when you apply for Medicare, whether you receive dialysis at home or at a facility, and whether you get a kidney transplant. If you are eligible for ESRD Medicare, you can enroll in Parts A and B together at any time. Part A will be retroactive up to 12 months, but it cannot start earlier than the first month you were eligible for ESRD Medicare.

Note: If you are a railroad worker with ESRD, you must contact Social Security—not the Railroad Retirement Board—to find out if you are eligible for Medicare.

Because Social Security and Medicare eligibility rules are complex, it is recommended that you call Social Security at 800-772-1213 to get the most accurate information regarding your particular situation.

© Medicare Rights Center. Used with permission.

The content is developed from sources believed to be providing accurate information. The information in this material is not intended as tax or legal advice. It may not be used for the purpose of avoiding any federal tax penalties. Please consult legal or tax professionals for specific information regarding your individual situation. This material was developed and produced by FMG Suite to provide information on a topic that may be of interest. FMG, LLC, is not affiliated with the named broker-dealer, state- or SEC-registered investment advisory firm. The opinions expressed and material provided are for general information, and should not be considered a solicitation for the purchase or sale of any security. Copyright FMG Suite.

 

Related Content

Best-Performing Asset Classes

Best-Performing Asset Classes

Bonds may outperform stocks one year only to have stocks rebound the next.

3 Estate Challenges for Blended Families

3 Estate Challenges for Blended Families

This article will help your clients with blended families think and prepare their estate strategy.

Why Regular Rebalancing Makes Sense

Why Regular Rebalancing Makes Sense

Without your knowing, your investment portfolio could be off-kilter.

 

Have A Question About This Topic?







Thank you! Oops!

AI Tools Changing Retiree Entrepreneurship

The impact that Artificial Intelligence (AI) tools can have on retirees with a consulting or small business venture.

Red Flags for Tax Auditors

Here are six flags that may make your tax return prime for an IRS audit.

Social Media: #NewestBusinessLiabilityRisk

Social media may be a modern imperative for businesses looking to grow and build their brand, but it also introduces risk.

View all articles

Tax Freedom Day

Assess how many days you'll work to pay your federal tax liability.

Federal Income Tax

Use this calculator to estimate your income tax liability along with average and marginal tax rates.

Estimate Your RMD

Help determine the required minimum distribution from an IRA or other qualified retirement plan.

View all calculators

A Bucket Plan to Go with Your Bucket List

A bucket plan can help you be better prepared for a comfortable retirement.

Jane Bond: Infiltrating the Market

Agent Jane Bond is on the case, cracking the code on bonds.

The Rule of 72

Do you know how long it may take for your investments to double in value? The Rule of 72 is a quick way to figure it out.

View all videos