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Health insurance is critical when you have a disabling medical condition. The good news is that if you receive Social Security Disability Insurance (SSDI), you automatically qualify for Medicare. However, you will likely have to wait to capitalize on that benefit.
While the federal Medicare program primarily serves people 65 and older, it is also available for younger adults who have a disability. Most SSDI recipients qualify for Medicare 24 months after they become eligible for disability benefits. The waiting period is waived for people with amyotrophic lateral sclerosis (ALS) or end-stage renal disease.
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The reasons for the delay are economic. When Congress voted in 1972 to expand Medicare to cover people with disabilities, it included the two-year delay to help mitigate the cost of adding those beneficiaries to the rolls, and to avoid replacing coverage some disabled workers would be able to get from their former employers through COBRA.
Aside from the waiting period, Medicare functions for people with disabilities much as it does for eligible older adults. You likely won’t have to pay for Medicare Part A (hospitalization coverage) if you paid Medicare taxes while you were working. However, you will have monthly premiums for Part B (physician and outpatient services) and for a Part D prescription drug plan if you opt to enroll in one. These costs may be deducted from your SSDI benefit.
How the waiting period works
The Social Security Administration (SSA) counts each month in which you are entitled to receive an SSDI payment toward the 24-month Medicare qualifying period.