How Long Does It Take to Get Medicare Coverage Through Social Security Disability (SSDI)?

Most SSDI recipients have to wait two years after being entitled to disability benefits to get Medicare. Learn about the exceptions.

Updated by , Attorney · UC Law San Francisco

All Social Security disability insurance (SSDI) recipients can receive Medicare coverage two years after the first month they're eligible for their monthly disability benefits. But this doesn't mean that every individual who is approved for Social Security disability will have to wait 24 months (two years) for Medicare coverage, as we'll explain below.

Who Can Get Medicare Coverage Early?

There are two exceptions to the two-year wait for Medicare for most SSDI recipients. If you suffer from one of the following medical conditions, you can receive expedited Medicare coverage sooner than normal:

  • End-stage renal disease (ESRD) with kidney failure. If you require ongoing dialysis or a kidney transplant, your Medicare coverage will begin three months after your dialysis began (whether or not you receive disability benefits).
  • Amyotrophic lateral sclerosis (ALS). Individuals with amyotrophic lateral sclerosis (ALS) qualify for Medicare as soon as they're eligible to receive disability benefit payments. Unlike other SSDI recipients, those who have ALS don't have to wait five months for benefits and Medicare to begin.

When Does Medicare Start for Other Disability Recipients?

After two years (24 months) of disability benefits, you'll be covered under Medicare Parts A and B. In general, the two-year waiting period for Medicare is calculated from your date of SSDI "entitlement"—when you're eligible to start receiving monthly benefits. This is usually the date your disability began, plus five months (due to the five-month waiting period for SSDI). (For more information on calculating your date of entitlement, our article on disability onset and backpay.)

But if your disability onset date is far enough back, you may have already "served" much or all of the two-year waiting period by the time you get a favorable decision (approval of benefits) from Social Security. (It can take one to two years to get a disability decision for some claims who go through the appeal process to a hearing in front of an administrative law judge.)

How Long After Disability Do You Get Medicare?

Your onset date, for payment purposes, can only be 17 months before your application date—that's because Social Security only allows a maximum of 12 months of retroactive benefits. So the earliest that you can become eligible for Medicare is one year after you apply for Social Security disability—if you've been disabled a long time.

(The 12-month maximum gets you to 12 months before your application date, plus five months for the Medicare waiting period, so the earliest your effective onset date can be is 17 months before the application date.)

On the other hand, disability applicants who apply for benefits only when they become disabled, and not before, have to wait much longer. The date that their Medicare coverage will start is more likely to be two years and five months (29 months) after they apply for disability.

Why the two-year waiting period for Medicare? Social Security has had this two-year waiting period in place since Medicare became part of the disability process. The waiting period was put in place as a cost-saving measure, so it's unlikely to change.

Learn more about the Medicare that comes with disability benefits.

How Do I Get Medicare After Two Years of Disability?

Once you've been receiving SSDI benefits for 24 months, or it's been 24 months since your entitlement date (see above), you'll automatically be enrolled in Medicare Parts A and B. Three months before your coverage starts, you should receive your new Medicare card. But Medicare isn't free. Social Security will start deducting your monthly Part B premiums from your SSDI checks.

Can I Get Medicaid While I Wait for Medicare?

Disability recipients with low income and low assets may qualify for the Medicaid program during the two-year waiting period for Medicare. Some states set their own rules regarding Medicaid eligibility, but those granted SSI at the same time as SSDI almost always qualify for Medicaid.

Even after you get Medicare coverage, if you have low income and assets, Medicaid can help pay your Medicare premiums and deductibles through state programs called Medicare Savings Programs.

Can SSDI Recipients Get Hospice Coverage?

Medicare does cover hospice care for SSDI recipients who are expected to pass within six months

But the five-month waiting period prevents many SSDI applicants with a terminal illness from using Medicare for hospice needs. Fortunately, all 50 states' Medicaid programs cover hospice for those with low income and low assets. States may vary regarding the length of hospice coverage they provide and the amount of inpatient care that's covered.

Updated January 31, 2023

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