SSD Disability: How Long Does It Take To Get Medicare If You Get Disability Benefits?

Unfortunately, you may or may not have coverage for medicare immediately available to you when you finally win your social security disability case. This is because the social security disability program has something known as the 24 month waiting period for medicare.

In many instances, of course, due to---

A) how long a disability claim has been in the system (from initial application all the way through to the disability hearing before a judge, the process can easily take between two and three years, or longer)

and

B) how far back a claim's disability onset date has been established,

---a person may find that medicare coverage is available after they are approved.

In other instances, however, particularly in cases where processing time has been minimal (the case was approved quickly) and the established onset date (this is when your disability began according to the medical evidence of record) is relatively recent, claimant's may find that the 24 month waiting period has not been "served out" by the time they get approved for disability meaning that they will actually have to wait for medicare coverage to kick in.

Of course, it does not seem logical for disabled beneficiaries to have to wait for health insurance coverage, or find some way to provide their own medical insurance benefits, or even pay out of pocket---because most Social Security disability beneficiaries have endured financial hardship and loss of insurance coverage during the time it took them to become entitled to disability benefits. But the federal government does have this mandatory waiting period for Medicare coverage, most likely as a cost saving device, and it is unlikely that they will ever do away with this waiting period.

So how long does it take to get Medicare if you are entitled Social Security disability? It takes two years from the month you are entitled to receive a monthly disability benefit to have Medicare coverage.

When do you become entitled? Your entitlement begins five months after your established date of onset (once again, established date of onset is when you became disabled according to the medical records). This is because, in addition to the 24 month waiting period for medicare, the social security administration has another 5 month waiting period for anyone approved for social security disability benefits.

The reasoning behind the five month waiting period? Again, it is a cost saving device and may be considered analogous to an elimination period on a private insurance disability policy. However, since the vast majority of individuals do not actually keep private disability policies, it's fairly plain that this waiting period is simply a convenient way for the federal government to bilk disabled individuals out of five months of their deserved disability benefits.

Additional Notes regarding disability benefits, medicare, and medicaid

If your Social Security disability benefit is low enough to enable you to receive SSI disability benefits as well (this is known as a concurrent claim and it applies to disabled individuals who were eligible to receive social security disability benefits, but would have received a low amount, and who also did not have more than $2000 in countable assets), you are in a better position as far as your medical needs are concerned.

For instance, if you are entitled to both Social Security disability and SSI, you are also entitled to Medicaid. Medicaid will pay your medical treatment until you receive Medicare, then both Medicaid and Medicare pay for your medical treatment.

But even if you are not entitled to SSI, you may be able to get help paying your Medicare premiums through Medicaid if you meet the income and resource limits for the MQB program, a program whose sole purpose is to pay the monthly medicare premium for those who qualify. MQB may be applied for at a local department of social services (in addition to being a former disability examiner, I am a former medicaid caseworker).