How Does SSDI Medicare Work?

Social Security Disability Insurance, or SSDI, provides monthly payments to people who can't work because of a disability. Medicare provides health insurance coverage for some people on SSDI, as well as for some elderly people, and some people who receive Supplemental Security Income (SSI). Medicare does not cover all health care services, however, and people must meet specific eligibility criteria before receiving Medicare.

Eligibility

• People become eligible for Medicare after they have qualified for SSDI for 24 months. They don't need to have been receiving SSDI for 24 months; they just need to have qualified for it for that length of time.

  If you receive SSDI, you'll receive information about how to sign up for Medicare in the mail shortly before you become eligible for it. Contact the Social Security Administration at 800-772-1213 if you have questions about when you will become eligible for Medicare.

Covered Services

• SSDI Medicare consists of several parts. Part A covers hospitalization, home health care, hospice services and nursing home care. Part B covers most outpatient services, like visits to doctors, laboratory tests, occupational and physical therapy, emergency medical care, some chiropractic care and outpatient mental health care. It also covers durable medical equipment like walkers, wheelchairs and hospital beds. Part D covers prescription drugs.

  Medicare does not cover some services, including some long-term care services, most eye care services and most dental care services. If you have questions about what Medicare does and does not cover, call 800-MEDICARE (800-633-4227) for more information.

Premiums

• People who receive SSDI receive Medicare Part A at no cost. They must pay premiums for Parts B and D. Premiums for Medicare Part D vary depending on the prescription drug plan you select. People who have low incomes can receive assistance paying the premiums. Contact the agency that administers Medicaid in your state to find out if you qualify for assistance with premiums.

Medicare Part C

• If you get SSDI Medicare, you can opt to sign up for a Medicare Part C plan, also known as a Medicare Advantage Plan. You can select from several different plans that replace Parts A and B and, usually, Part D.

Using Medicare

• To use SSDI Medicare, just take your red, white and blue Medicare card with you to medical appointments. Check with your health care providers before you go to make sure they accept Medicare, though. You must pay co-insurance for some services. If you also qualify for Medicaid, Medicaid may cover costs not covered by Medicare.