How Long Does It Take to Get Medicare Coverage Through SSDI?

All Social Security disability insurance (SSDI) recipients can receive Medicare coverage two years (24 months) 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 two years for Medicare coverage, as we'll explain below. Knowing how the Medicare timelines work can help you plan for your health care needs after you apply for SSDI.

Can You Get Medicare Coverage Early If You're Disabled?

There are just 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. Your date of entitlement 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, see our article on disability onset and backpay.)

If your disability onset date occurred long enough in the past, you may have already completed part or even all of the two-year Medicare waiting period by the time the Social Security Administration (SSA) approves your disability claim. In fact, this often happens, because it can take one to two years to get a disability decision for applicants who have to appeal their case and go before an administrative law judge to receive a final decision.

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?

You don't need to take action; you can just wait to hear from Medicare. 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.

How Long Can You Keep Medicare After Disability?

You can keep Medicare as long as you're still disabled, sometimes even if you return to some form of work. You don't have to pay Medicare Part A premiums for the first 93 months after doing a trial work period. After the end of 93 months, you may be able to get Medicare through the Premium-HI program, and you may be able to get your Part A premiums paid by the QDWI program. But to qualify for Premium-HI coverage (HI stands for Hospital Insurance), you must have lost your disability benefits because you earned over the SGA limit and not because Social Security determined that you're no longer disabled. (42 U.S.C. § 1395i–2a(a).)