What is the Disability Criteria for Medicare?

Medicare benefits can often be connected to disability benefits. Generally, having a disability allows you to apply for Medicare benefits before you turn 65, which is the normal age for Medicare enrollment. However, to do so, your disability must fall into the criteria that determine eligibility to receive Social Security Disability program benefits.

Social Security Disability and Medicare

• If you are receiving Social Security Disability benefits, you are automatically enrolled in Medicare after 24 months of receiving disability benefits. To qualify to be enrolled in Medicare, your disabilities must meet the SSD program criteria: you must have a full-term disability. A full-term disability means that your condition will last one year or more. (If your condition lasts for a period shorter than one year but it will lead to death, then it is also considered full-term.) Other than proving that your condition is full-term, you must also show that it keeps you from working.

Blindness and Medicare

• If you are a blind person younger than 65 years of age and you receive either SSD benefits or Supplemental Security Income benefits, you also qualify to receive Medicare benefits. As with other disability conditions that qualify you to receive SSD benefits, you only get Medicare after 24 months of having received Social Security benefits. If you receive Supplemental Security Income, your condition does not necessarily need to make you unable to work. You do not need to sign up or apply for Medicare, since you will be enrolled automatically after your 24th month of disability.

Railroad Retirement Board Disability

• If you receive disability benefits from the Railroad Retirement Board, you also qualify to enroll in Medicare before age 65. Two disability requirements for receiving benefits and enrolling in Medicare are having a permanent medical condition that prevents you from working and being 55 years of age or older and blind, with another condition that also prevents you from working. If your disability meets these requirements and you receive RRB benefits, you will also be automatically enrolled in Medicare after 24 months of receiving benefits. Once you turn 65 years of age, you will also be automatically enrolled.

Medicare Part C and Part D

• If you have a disability that meets the criteria mentioned above and you receive Social Security or RRB benefits, you are automatically enrolled in Medicare Part A and Part B. However, you are also allowed to enroll in Part C and Part D. The main difference with Part A is that you are not automatically enrolled and you have to pay monthly premiums for its coverage. You can sign up during the time period starting three months before your 25th month of benefits and ending three months afterward.