The government has made many policies and schemes for our betterment. These policies and schemes help us to lead an easy life. With the increasing technological advancement, these policies have become easy to grasp and user friendly.

One such policy initiated by the government is Medicare Coverage. You must have heard about medicare coverage of people above  65 years of age (senior citizens). However, the government also provides Medicare coverage to those who come under the list of Social Security Disability Insurance (SSDI). 

Social Security Disability Insurance (SSDI) is managed by the Social Security Administration SSD which aims to provide income supplements to people who are physically restricted in their ability to employ because of their notable disability. In short, it works to provide people with disability monetary assistance. Thus, we can say it provides benefits to disabled people, and Medicare coverage is one such among many.

What is Medicare Coverage?

As mentioned earlier, Medicare coverage is the policy by SSDI to provide medical facilities to disabled people. Basically, it is like the insurance plan which takes care of your medicare expenditures. These expenditures include hospital bills, hospital stays, medicines bills, and also other facilities such as nursing facilities for home, walkers, wheelchairs, etc.

It has four parts ABCD which covers most of the medical requirements but not all. Thus, it is very important to know beforehand the pros and cons of any such policy before taking it. Thus, beware. Medicare has many such types of policies according to the requirement of the customers. Therefore, take the plan which suits you the best and choose it wisely. Take your final decision after clearing all your doubts!

How to get this Medicare coverage?

As soon as you get accepted as people with disability under the list of Social Security Disability Insurance (SSDI). You will be get automatically enrolled for the Medicare Coverage facility provided them.

Medicare Waiting Period
Medicare Waiting Period

You don’t need to get this facility separately if you are recognized under the disability list of SSDI then you automatically get the benefits of it.  You just have to fill the disability form by SSDI and if it gets approved you automatically get enrolled for medicare coverage benefits. All these medicare coverage plans have different numbers of parts and have their own rules.

Medicare Under 65

Medicare coverage given by SSDI does not have any age criteria. The plan of your Medicare coverage completely depends upon the type of disability and your financial conditions. Thus, clearly, Medicare coverage does not depend upon your age.

You just need the approval of disability from the Social Security Administration (SSA) and meet their requirements.

They have mainly two requirements:

  • What are the exact disability that keeps you for earning and the proof of it
  • That disability should be there for at least a year for the approval

What is the Medicare Waiting Period?

Once you fill the disability form by SSA and get their approval, the next step is that you have to for 2 years to get its benefits. Once your form is approved you will receive mail regarding it during your 22nd month of benefit. Your waiting period starts on the date of your entitlement date as calculated by the SSDI. This is the date they think you are eligible for getting Medicare benefits monthly.

Medicare Waiting Period
Medicare Waiting Period

It is also dependent on the date of your disability. They check the date of starting of your disability and then there is the 5-month waiting period of SSDI. For instance, if you become disabled in January 2020, after the waiting period of 5 months and if you did not get enrolled at the time of your disability you will get benefits by 2022.

However, there is one exception to the medicare waiting period for people over 65. If you are over 65 there is no such waiting period for you. For instance, if you are 64 and you apply for the disability form then you don’t have to wait for two years. 

You will get the medical coverage as soon as you turn 65. But if you apply at any other time you have to wait for two years. Americans are eligible to enrol up to three months before they turn 65.

Medicare Waiting Period Waived

There are certain exceptions in the medicare waiting period. These exceptions lie in the case of specific diseases. If you have such life-threatening diseases you don’t have to wait for two years, your medicare coverage starts earlier 

These specific diseases are: 

  • Amyotrophic Lateral Sclerosis (ALS) or Loh Gehrig’s Disease: ALS commonly known as Loh Gehrig’s Disease is a chronic condition that needs proper health care for functioning. There has not been any permanent cure to ALS but one can lead to a better life with all-time medical assistance. 
  • In this condition, one loses the control of their muscles and it gets worse and severe over time. Since in such a condition the patient is not able to function properly and needs immediate assistance the medicare waiting period is waived off. 
    If someone is diagnosed with ALS they will get medicare coverage within a month of their enrollment in SSDI.
  • End-Stage Renal Diseases (ESRD): ESRD is also a chronic condition related to the kidney. In this condition, your kidney grows weak and unable to function to meet bodily needs. This condition grows worse with time and ultimately leads to a kidney transplant. 
    Similarly, in this condition, one does not have to wait for two years, their medical coverage starts on the first day of their four months dialysis process. After getting the medical coverage you can go for home dialysis easily. 
    Also, if you apply after some time for your treatment it will still give you medical coverage counting its four-month period.

Things to keep in mind

  • If you or any of your family members are disabled or above 65 don’t forget to get the benefits provided by SSDI on time.
  • However, be cautious while choosing your plan.

Also Read: 7 Ways To Reduce Unexpected Medical Bills