November 22, 2011
Social Security Disability and Medicare: Benefits for Disabled Individuals
If you're permanently disabled, or if you have Lou Gehrig's Disease or kidney failure, you can get financial help from Social Security and Medicare. To be considered "permanently disabled," your doctor must confirm that you are unable to work for at least twelve consecutive months. Being "unable to work" means you cannot perform your job functions because of the disability, and you cannot find a new line of work because of age, education or impairment. You must follow your doctor's prescribed treatment plan to continue to qualify. It's a good idea to keep up-to-date medical records.
Qualified disabled individuals can apply for Social Security Disability or Railroad Retirement Board (RRB) disability to recover lost wages. Once you qualify for Social Security Disability or RRB benefits, you can also apply for Medicare Disability benefits to cover your hospital, medical and/or prescription drug expenses.
Medicare qualified disabilities
To be eligible for Medicare Disability benefits you must:
- Be approved for Social Security Disability benefits because of your permanent disability
- Have End-Stage Renal Disease (ESRD or kidney failure)
- Have Amyotrophic Lateral Sclerosis (ALS or Lou Gehrig's Disease)
Automatic enrollment in Medicare Parts A and/or B
If you are approved for Social Security Disability or RRB benefits because of your permanent disability, Medicare Disability may be automatic. Once you have been collecting Social Security Disability or RRB benefits for two years, you will be automatically enrolled in Medicare Part A (hospital insurance). If you live in any of the 50 United States or the District of Columbia, you will also be automatically enrolled in Medicare Part B (medical insurance).
If you have Lou Gehrig's disease, you will be automatically enrolled in Medicare Parts A and/or B as soon as you start collecting your Social Security Disability or RRB benefits.
If you have ESRD, you will have to sign up for Medicare Disability Parts A, B and D manually.
When to enroll manually for Medicare Disability
Even with Automatic enrollment in Medicare Part A, some will need to enroll manually for Medicare Part B (for example, if you live in Puerto Rico). You can also enroll in Medicare Part D for prescription drug insurance.
If you are permanently disabled, or if you have ESRD, you are eligible for Medicare Disability in the 25th month after you begin collecting Social Security Disability benefits. You can begin the enrollment process anytime from three months before your eligibility through four months after your eligibility for Medicare Disability. For example, if you began collecting Social Security Disability benefits in April of 2011, your 25th month will be May of 2013. You can enroll in Medicare Disability as early as February of 2013. Your Initial Enrollment Period lasts seven months. However, it's best not to wait until the last minute. Your coverage will begin in July of that year, unless you enroll too late.
If you have Lou Gehrig's Disease, you can get Medicare Disability beginning the first month you get Social Security Disability benefits. Enroll in Medicare Disability at the same time as you apply for Social Security Disability benefits.
How to apply manually for Medicare Disability
Here's how to enroll in Medicare Disability Parts A, B and/or D:
- Apply online at www.socialsecurity.gov/medicareonly/.
- Call 1-800-772-1213 Monday through Friday between the hours of 7 a.m. and 7 p.m. to make an appointment. TTY users should call 1-800-325-0778.
- Visit your local Social Security office.
