Social Security Disability and Medicare: How Does It Work?

Most often associated with seniors, Medicare was created to support those 65+ or younger than 65 with disabilities. So how does Medicare come into the picture if you are already receiving Social Security disability benefits? We highlight the relationship between Social Security disability and Medicare below so you can better understand your options.

What is Medicare?

Medicare is a national health insurance program that provides coverage to help cover specific services for those aged 65 and older or younger individuals with disabilities. There are three primary parts of Medicare that offer different levels of care to choose from based on needs:

  • Part A – Hospital and inpatient health care coverage
  • Part B – Medical and outpatient health care coverage
  • Part D – Prescription coverage

Social Security Disability and Medicare

If you are under the age of 65 and have a medical condition for which you are receiving Social Security disability benefits, you will likely be eligible for Medicare after a 2-year qualifying period, beginning the first month after you become eligible for disability.

Not every person approved for disability benefits has to wait the full 24 months to receive Medicare coverage – there are a couple of conditions that qualify you sooner: Amyotrophic Lateral Sclerosis (ALS) or End-Stage Renal Disease (ESRD). This can help to provide relief for those with high healthcare costs due to their disability or medical condition.

What Are Medicare’s Benefits for Disabled Individuals?

Medicare health coverage is the same, whether you qualify based on your age or based on disability. If you are eligible, you will have access to Parts A, B, and D of Medicare coverage, which can include a full range of benefits such as home health, hospital, nursing home and physician services.

This can be hugely helpful for eligible recipients for many reasons, including:

  • The health care services you use Medicare for do not need to be related to your disability to be covered.
  • No underlying conditions or pre-established illnesses will disqualify you from obtaining Medicare coverage.
  • Individuals who meet the Social Security disability benefits criteria are automatically enrolled in Parts A and B – you should expect to receive a Medicare card in the mail.

Medicare Coverage for Working People with Disabilities

If a disabled individual is able to return to work, Social Security disability payments will stop if they are engaged in what’s known as substantial gainful activity (SGA). This is generally defined as any work that is performed for profit, and as of 2021 means earning more than $1,310 per month, or $2,190 per month if you are blind.

If you meet the standards but don’t qualify for Social Security disability benefits, you can still purchase Medicare premiums for Part A and Part B.

Contact the Disability Attorneys at Woodruff & Mathis

Are you wondering whether you qualify for Social Security disability benefits and, if so, how Medicare plays a role in your health care? At Woodruff & Mathis, our experienced team of disability attorneys will work with you on each aspect of your disability process.

To learn more about your options, please request an appointment with our attorneys at Woodruff & Mathis today.