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Do you have Medicare coverage because of a medical disability? If you recover from the health condition that qualified you for Medicare, you might lose your Medicare coverage.
However, you will not necessarily lose your Medicare coverage simply because you are no longer eligible to receive Social Security benefits. How do you know when your Medicare coverage may terminate? Learn more in this article.
Who decides if I get Medicare coverage if I’m disabled?
The Social Security Administration (SSA) decides whether you’re eligible for Social Security benefits, including Medicare coverage. The SSA sorts disabilities into three categories:
- Medical improvement expected
- Medical improvement possible
- Medical improvement not expected
The SSA considers whether your medical condition will likely improve so you will be able to return to work. The agency does eligibility reviews from time to time to see if your condition has improved. They look at your current condition and use nationally recognized medical guides and other sources to decide whether you qualify.
For those who suffer from severe and permanent disabilities, there is no “expiration date” set on your Social Security disability payments. As long as you remain disabled, you will typically continue to receive your disability benefits until you reach retirement age. At that point benefits convert to retirement benefits and are payable until death. Your Medicare coverage usually continues uninterrupted.
Can I get Medicare coverage when my disability benefits stop?
It may be possible for your Medicare coverage to continue when your Social Security Administration (SSA) disability benefits stop. For example, your Medicare benefits might continue:
- If you have not recovered from your qualifying medical condition
- If your SSA benefits stopped because you were able to work
The SSA has several types of programs designed to help people with disabilities return to work. For example, the Extended Period of Medicare Coverage rule might let you receive Medicare coverage for a limited time after you return to work. Even after this extended Medicare coverage ends, you may be eligible to purchase Medicare Part A and Part B by paying monthly premiums if you still have the medical disability.
Does my Medicare coverage end if I get better?
To prevent taxpayer money from being misused, the SSA reports to Medicare when you’re no longer eligible for Medicare disability benefits. You’ll be notified if your Medicare coverage will stop because you have recovered from the disability that made you eligible. Your Medicare coverage generally stops the month after you receive this notice.
If you lose your Medicare coverage because you have recovered from a disability, you might have other options for health-care coverage. If you work, you may have group health coverage from your employer or your spouse’s employer. In some situations you might qualify for your state Medicaid program or an Obamacare plan.
You can contact your local SSA office and speak with a counselor about your eligibility for continued Medicare coverage. Or call the SSA at 1-800-772-1213. TTY users can call 1-800-325-0778. Representatives are available Monday through Friday, from 7AM to 7PM.
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