All individuals 65 years of age or older who have been legal residents of the United States for at least 5 years are eligible for Medicare. People with disabilities under 65 may also be eligible if they receive Social Security Disability Insurance (SSDI) benefits. Some medical conditions may also help you become eligible to enroll in Medicare.
If you are under age of 65, you must be approved for Social Security Disability Income (SSDI) to receive Medicare. Individuals with end-stage renal disease (ESRD) are automatically eligible for Medicare.
As mentioned above, you must receive SSDI benefits to be eligible for Medicare. SSDI benefits are based on work credits earned through Social Security, Railroad Retirement or Medicare-covered government employment. If you do not have enough credits and do not qualify for SSDI, you may qualify for Supplemental Security Income (SSI). For more information, see Supplemental Security Income.
To qualify for SSDI, you must be unable to work because of a medical condition(s) for at least 12 month. Once you are approved for SSDI, you must wait five months for your income benefits to begin, and an additional 24 months before Medicare benefits begin.
However, there are 2 exceptions:
· Amyotrophic Lateral Sclerosis (Lou Gehrig’s disease). If you have Amyotrophic Lateral Sclerosis (Lou Gehrig’s disease), you are eligible to receiveMedicare the first month you get SSDI monthly income benefits.
· End-Stage Renal Disease. If you have end-stage renal disease (ESRD), you are eligible to receive Medicare within 3 months of your first dialysis treatment, regardless of whether you apply and qualify for SSDI. You are eligible for Medicare solely on the basis of having ESRD.
If you are unable to work because of ESRD or other disabilities, you can apply for SSDI benefits. If you qualify, you will also be eligible for Medicare under an additional category of eligibility after 29 months, as long as your disability continues. If you have another disability (in addition to ESRD) or later develop other health conditions that qualify you for disability benefits, the Medicare benefits you receive due to disability will continue, even if you have a successful kidney transplant and lose Medicare coverage based solely on your ESRD eligibility.
The Social Security reviews eligibility for SSDI. If your condition improves or you have a successful kidney transplant, you can lose your SSDI benefits and Medicare. However, if you no longer qualify for SSDI because your condition improves or you successfully complete a trial work period, you may still be able to keep your Medicare benefits. If you lose your eligibility for SSDI and Medicare, and you have another qualifying condition, you may be eligible for Medicare coverage without the 29-month waiting period described above. However, you must apply for SSDI within five years of your original qualifying condition.