Do You Automatically Get Medicare With Social Security Disability Benefits: 24 Month Rule

Many individuals want to know “do you automatically get Medicare with social security benefits”.

If you are collecting social security disability benefits and are under the age of 65, you may be wondering how to get Medicare coverage. Don’t worry – we’re here to help!

In this blog post, we will discuss what each of these benefits is, how to qualify for Medicare and what benefits you can expect. We will also provide some tips on how to choose the right Medicare plan for your needs.

Lastly, will also go over some common frequently asked questions.

So, whether you are just starting to explore your options or you are ready to enroll in Medicare, read on for helpful information!

Table of Contents

A patient and doctor holding hands.

What is Medicare?

Medicare is a health insurance program that helps pay for hospital and skilled nursing facility stays, doctors’ visits, medical supplies, and services. It covers people 65+ years old or disabled people under 65 who meet their eligibility requirements. The purpose of Medicare is to help pay a portion of your medical expenses, not cover all bills completely.

There are four parts to Medicare: Part A, Part B, Part C, and Part D. Each part has its own specific benefits. For example, with Medicare Part A & Medicare Part B, you can receive care through a doctor’s office, specialist, and hospital which you choose during your time of need. With Medicare prescription drug coverage (Part D), you can get help paying for prescriptions doctors prescribe as part of treatment plans.

What are Social Security disability benefits?

Social Security disability benefits are payments that the government makes to people who can’t work because of a health problem. You may be able to get these benefits if you have a physical or mental illness, injury, or medical condition that keeps you from doing any kind of substantial work for at least 12 months.

You don’t have to be retired to get Social Security disability benefits. And you don’t need to have paid into the Social Security system for years. You can apply for disability benefits even if you’ve never worked in your life.

There are two ways to get Social Security disability benefits: through the regular program or through Supplemental Security Income (SSI). The regular program is for people who have worked in the past and paid Social Security taxes. SSI is for people with low income and few resources.

Many people with ALS receive their social security Disability Insurance automatically because they meet certain requirements like having been employed long enough and paying taxes into the social security system

How do you qualify for Social Security disability benefits?

In order to qualify for Social Security disability benefits, you must be unable to work because of a medical condition that is expected to last at least one year or end in death. You must also have worked long enough and paid Social Security taxes.

Your medical condition must keep you from working for at least one year or lead to your death.

You must have worked and paid Social Security taxes for a certain amount of time.

How do you qualify for Medicare?

There are many requirements and qualifications for eligibility. In order to qualify, you must be a United States citizen or have been a legal permanent resident for five continuous years. You must also have worked long enough and paid Medicare taxes.

In addition, there are other factors that may affect your eligibility, such as age and disability. If you are already receiving Social Security benefits, you would qualify for Automatic Enrollment into Medicare Part A and Part B. 

For example, if you receive Social Security Disability benefits, the card will be sent automatically after 24 months of receiving them. If you turn 65 years old while still receiving Social Security Disability benefits, then you will be automatically enrolled in both Part A and Part B of Medicare.

If you receive social security widow/widower benefits, they will send a Medicare card after 24 months or when you turn 65 years old–whichever comes first. The three months before turning 65 will cover Medicare for the month of your birthday; the 60 days after turning 65 allows seniors to enroll in Medicare without penalty (for coverage starting on the 1st day of the month that follows their birth month). 

There is also an eight-month enrollment period for those who want to delay enrollment without penalty (involving coverage starting in the month after their birth month).

The General Enrollment period is January 1 through March 31 of each year. If you are covered by an employer group health plan, you can delay enrollment in Medicare without penalty. To avoid a penalty, you can contact the Social Security Administration to find out when you should enroll in Medicare Part B.

What are the differences between Medicare and Medicaid?

Medicare and Medicaid are both government-funded health insurance programs that cover eligible individuals. They provide different types of benefits, and people with disabilities can qualify for either program.

Medicare is for people who have a disability before the age of 65, while Medicaid is for people with disabilities at any age. Medicare provides a link to help you find your local Social Security office and other organizations in your state at http://www.medicare.gov/contacts/. It covers eligible individuals for premiums, cost-sharing, and prescription drug benefits.

Medicaid is available to individuals who have an income of at least 100% of the poverty line in 2022. If you apply for and receive Marketplace coverage and subsidies, your eligibility for those subsidies will end. If you keep both Medicare Part A and Part B, Medicare will be the primary payer. Medicaid also provides help with premiums, cost-sharing, and prescription drug benefits like Medicare does.

Both programs are important resources for people with disabilities, but they offer different types of coverage depending on each person’s needs

What are the differences between Medicare and private health insurance?

There are a few key differences between Medicare and private health insurance.

First, Medicare is a government-run program, while private health insurance is offered by individual companies.

Second, Medicare typically has lower premiums and deductibles than private health insurance.

Third, Medicare covers services that are not covered by private health insurance, such as dental and vision care, mental health care, and emergency room visits.

Finally, people with disabilities will have to pay more if they switch from Medicare to private health insurance.

Healthcare Cost for Older Adults

What are the costs of Medicare?

As with any government program, there are costs associated with Medicare. However, these costs vary depending on your age and whether or not you qualify for premium-free Part A.

Most people do not have to pay a monthly insurance premium for Medicare Part A because they either paid taxes while working or meet other eligibility requirements. If you did not work for 40 quarters, reach out to the social security office to determine your Part A monthly premium.

Part B premiums also vary based on your income and type of coverage, but the majority of enrollees pay an average of $170.10 per month in 2022.

Medicare Advantage plans–private health insurance plans that offer all the benefits of Original Medicare–cost an average of \$1,500 per year in addition to monthly premiums, deductibles and copayments. However, depending on the Medicare Advantage plan selected you could pay as much as $7,550 for 2022.

However, some people may qualify for lower rates or even free coverage through these plans.

To learn more about the costs associated with Medicare, contact one of our Medicare insurance agents.

If I'm eligible for Social Security Disability Benefits, when does Medicare coverage start?

If you’re receiving Social Security Disability benefits (SSDI), you are automatically enrolled in Original Medicare after a waiting period of 24 months. This means that, as long as you’ve been a U.S citizen or legal permanent resident for at least five continuous years before going on SSDI, Medicare will start paying for your health care costs two years after you become eligible for disability benefits.

However, there are some exceptions to this rule: if you have ALS, for example, you’re automatically enrolled in Medicare for the first month of receiving disability benefits from Social Security or the Railroad Retirement Board. And if your kidneys have ceased functioning at 10 to 15% of their normal capacity, dialysis or a kidney transplant are your only options.

For more information about when and how to sign up for Medicare—including information about enrolling in a Part D prescription drug plan—you can contact the Social Security Administration at 1-800-772-1213 from 7AM to 7PM Monday through Friday, or visit your local office between 7AM and 7PM on Mondays through Fridays. You can also get help online by visiting www.socialsecurity.gov/medicare/.

If you get SSDI benefits and are in a 24-month waiting period before getting Medicare

If you are receiving Social Security Disability Income (SSDI) benefits, you may have to wait up to 24 months before you become eligible for Medicare. During that time, you will need to have some other form of health insurance coverage.

You can apply for Medicaid coverage while waiting to get Medicare. If you are eligible for Medicaid, your eligibility may continue even after you get Medicare.

You also need to apply for Marketplace coverage if you’re turned down for Medicaid. To qualify, be sure to include your SSDI income on your Marketplace application.

If someone in your household is getting SSDI benefits and is in a 24-month waiting period before getting Medicare, that person’s spouse or former spouse may be eligible for benefits through the Marketplace.

Can I use Social Security benefits to pay my Medicare premiums?

Medicare Part A

Most people will receive 40 credits from the Social Security Administration in 10 years of work over their lifetime. That means they’ll have enough to qualify for premium-free Medicare Part A. If you’re not one of those people, here are some other ways you can get Part A without paying a premium:

If you’re married and your spouse is eligible for SSDI or retirement benefits, then you can pay nothing for your Medicare premiums.

You can also receive Part A if you qualify because of disability at any age.

If you have amyotrophic lateral sclerosis, your premiums will be $0 for the first few years of Part A coverage.

If you need to pay a Part A premium, your bill will come every month and you can pay online or by mail.

Medicare Part B

The premiums for Medicare Part B are deducted from any Social Security benefits. The standard cost of the premium is $170.10 in 2022, but some people might pay less because their increase in Social Security benefits outweighs the increase in the Part B premium.

You have a higher chance to pay for Medicare if your individual income is over $91,000 or joint income is over $182,00. However, you might be eligible for a lower cost or even free Part B if you have low income.

Your premiums will go up in 2022 if you are making more than $91,000 as an individual or more than $182,00 as a couple. In this case, you’ll need to manually pay your premium if you don’t receive Social Security or RRB benefits.

Medicare will send you a bill every 3 months, which you can either pay online or by mail.

Medicare Part C and Part D

There are two parts to Medicare: Part A and Part B.

Part A is hospital insurance, while Part B is medical insurance.

Part C (Medicare Advantage) and Part D (prescription drug coverage) are offered by private companies, such as insurance companies or HMOs. You must have Parts A and B in order to enroll in a Part C or D plan.

Some companies offer a premium for their plans, while others have no premium or a free plan. You will have to contact your insurance company in order to deduct your premiums from Social Security. This can take a few months, so you might be asked for a large payment at first. Your monthly deduction will occur after all the details are set up with your insurance company and plan provider

If my premiums aren't automatically deducted, how do I pay my Medicare bills?

If you have a premium plan, your monthly premiums will be deducted from your Social Security disability payments. If you do not have an insurance company or are on an HMO, then you will have to go to your local Social Security office. You can also pay by mail or over the phone.

If you have a free plan, then you will receive a card in the mail that allows you to get your Medicare services. You can also pay by mail or over the phone.

What about Part C and Part D?

Medicare Part C and Medicare Part D plans are optional. You can choose to have just Part A, just Part B, or both Parts A and B. You can also choose to have a Medicare Advantage plan (Part C) or a Prescription Drug Plan (Part D).

Each plan varies in price, with more expensive options providing more coverage than cheaper options. Plans will let you know if there’s anything you should be aware of with each payment type, such as added fees or time delays.

To sign up for a Medicare Advantage plan or a Prescription Drug Plan:

1) Contact the company that sells your plan.

2) Your first payment could be large since it covers multiple months at once. The company will walk you through the details and let you know how long it will take for automatic payments to begin.

3) Premiums are deducted after everything is set up – your premiums will be deducted once per month and your bills will automatically be paid from the deducting account.

There are copays and deductibles (out-of-pocket costs) for individuals with disabilities.

When you’re on Social Security Disability Insurance (SSDI), you still have to pay your share of the costs. This includes copays and deductibles for doctor visits, hospital stays, prescription drugs, and other medical services. 

The good news is that there are a number of programs that can help you with these costs.

Original Medicare (Parts A and B) may be a better option than Medicare if you’re not enrolled in employer insurance. That’s because there are no copays or deductibles for most services, and the premiums are usually lower than private insurance plans. However, there are some exceptions: 

For example, Part B has a $183 deductible per year for each person. And if you go to a doctor who doesn’t accept Medicare assignment, you’ll have to pay the entire cost yourself.

There are also programs available to help people with their out-of-pocket costs. The Extra Help program pays part of your drug costs when you fill prescriptions at a pharmacy. Medicaid can help cover some of your health care costs too–including copays and deductibles–if your income is low enough.

Can I sign up for a Medicare Supplement Plan while under 65 and disabled?

Yes, you can sign up for a Medicare Supplement Plan if you are disabled and under 65 years old. However, the plan will not kick in until 24 months after your disability benefits start.

If you have any other health insurance, make sure you contact the company to see what your benefits are before signing up for a Medicare Supplement Plan.

We recommend finding out about the different plans 90 days prior to your 24th month of receiving disability benefits.

Frequently Asked Questions

Will my Disability benefits change when I turn 65?

If you are disabled and receiving Social Security Disability benefits, your disability benefits will not change when you turn 65.

Can I get Medicare at age 62?

No, you will not get Medicare automatically. You need to apply for a Social Security disability insurance card and your own Medicare coverage at age 65 or older.

Can you get Medicare early if you are disabled?

Yes, Medicare is available to those individuals who have been disabled and receiving social security disability benefits for 24 months.

How long will I get to keep medicare if I go to work?

If you go back to work for a limited time, or if you are working and have income from another job, your Medicare coverage may not be the same. You will need to contact Social Security to find out if your Medicare coverage will continue during this time.

What happens if I have cobra and enroll in medicare?

If you have COBRA coverage and are eligible for Medicare Part A and B, then you must make a special request to the Social Security Administration (SSA) to enroll in Medicare.

How do people with Disability sign up for a Medicare Advantage Plan or Medicare Policy?

Integrity Now Insurance Brokers is a health insurance agency that specializes in Medicare. Give them a call and request a Medicare quote. They will review all of the different health insurance coverage options to determine which Medigap plan is best.