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Home › What Does Medicare Cover? › Medicare For Those With Disabilities

Medicare For Those With Disabilities

by David Bynon, March 30, 2018

Medicare is not only for those 65 and older. If you are disabled due to injury or disease you may qualify as well. It’s to your benefit to begin looking into Medicare disability benefits as soon as possible.

Facts About Medicare for Those with Disabilities

Your first step is to apply for Social Security disability benefits. Once this is approved the next step depends on your condition.

Under most circumstances, once you have had Social Security or Railroad Retirement benefits due to disability for twenty-four months you will be automatically enrolled in Medicare. About three months before your twenty-fifth month of disability benefits your Medicare card will be mailed to you.

If at this time you don’t want to pay the premiumA premium is an amount that an insurance policyholder must pay for coverage. Premiums are typically paid on a monthly basis. In the federal Medicare program, there are four different types of premiums.  and receive Medicare Part BMedicare Part B is medical coverage for people with Original Medicare benefits. It covers doctor visits, preventative care, tests, durable medical equipment, and supplies. Medicare Part B pays 80 percent of most medically necessary healthcare services., you should follow the instructions on the card. You should be aware, however, that if you decide later that you need it, you will have to pay the penalty of 10% of the cost of the premium for every 12 month period you could have had Part B but didn’t take it, and this will last as long as you have Medicare Part B.

If you are under 65 and have ALS (Amyotrophic Lateral Sclerosis, or Lou Gehrig’s Disease) there is no waiting period. Your benefits begin the first month you get SS benefits.

If you have End-Stage Renal DiseaseEnd-Stage Renal Disease (ESRD), also known as kidney failure, is a condition that causes you to need dialysis or a kidney transplant. People with ESRD are eligible for Medicare coverage regardless of age. you are not automatically enrolled in Medicare, but you can apply if you have worked the required amount of time according to Social Security or the Railroad Retirement Board, or if you are the spouse or dependent child of someone who has. Contact Social Security for details. You would need both Medicare A and B to cover certain dialysis and kidney transplant services. The coverage usually starts in the fourth month of dialysis treatments.

If you are under 65 and have diabetes, Congestive Heart Failure (CHF), or other severe or disabling chronic conditions, you may not qualify for Medicare disability benefits. However, you might qualify for a Medicare Advantage Special Needs Plan (SNP). Some of the conditions covered by SNP plans include:

  1. Chronic alcohol and other dependencies
  2. Autoimmune disorders
  3. Cancer (excluding pre-cancer conditions)
  4. Cardiovascular disorders
  5. Chronic heart failure
  6. Dementia
  7. Diabetes mellitus
  8. End-stage liver disease
  9. End-Stage Renal Disease (ESRD) requiring dialysis (any mode of dialysis)
  10. Severe hematologic disorders
  11. HIV/AIDS
  12. Chronic lung disorders
  13. Chronic and disabling mental health conditions
  14. Neurologic disorders
  15. Stroke

In conclusion, there are special health care programs for those with disabilities. Look into your options as soon as possible so you can get the help you need.

Filed Under: What Does Medicare Cover?

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