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How Social Security Disability and Medicare Benefits Work Together

You may be able to receive benefits from Social Security and Medicare before you turn 65 if you’re permanently disabled. You might also qualify if you have Lou Gehrig’s disease (amyotrophic lateral sclerosis, or ALS) or permanent kidney failure (end-stage renal disease, or ESRD). Generally, your doctor must confirm that you are unable to work for at least 12 consecutive months in order for you to qualify for Social Security disability benefits. For more information about eligibility for Social Security disability benefits, see the SSA website.

If you have a disability, you can apply for disability benefits from the Social Security Administration (SSA). If you worked for a railroad, you might qualify for disability benefits from the Railroad Retirement Board (RRB). If the SSA or RRB determines that you qualify for benefits, you may be eligible for Medicare benefits, but not right away in most situations.

Who qualifies for Medicare under the age of 65?

To be eligible for Original Medicare (Part A and Part B) benefits before you turn 65, you must meet one of the following criteria:

  • You have received SSA or RRB disability benefits for 24 consecutive months
  • You have amyotrophic lateral sclerosis (ALS or Lou Gehrig’s disease)
  • You have end-stage renal disease, also known as ESRD. This is permanent kidney failure requiring a kidney transplant or a regular course of dialysis

Who is automatically enrolled in Medicare Part A and Part B?

If you are approved for SSA or RRB benefits because of your permanent disability, Medicare enrollment may be automatic. Once you have been receiving SSA or RRB disability benefits for two years (24 consecutive months), you will be automatically enrolled in Medicare Part A (hospital insurance) during the 25th month. If you live in any of the 50 United States or the District of Columbia, you will also be automatically enrolled in Medicare Part B (medical insurance).

If you have Lou Gehrig’s disease, you will be automatically enrolled in Medicare Part A and Part B during the first month that you start receiving your SSA or RRB disability benefits.

Who needs to enroll manually?

In some cases, Medicare enrollment doesn’t happen automatically. For example, if you:

  • Have end-stage renal disease (ESRD), which is permanent kidney failure requiring regular dialysis treatments or a kidney transplant
  • Live in Puerto Rico and qualify for automatic enrollment in Medicare Part A (you still typically need to enroll in Part B manually)
  • Have reached your 25th month in a row of receiving disability benefits (or your second month, if you have Lou Gehrig’s disease) and haven’t received Medicare enrollment information

– then sign up for Original Medicare through Social Security (or the RRB, if you worked for a railroad) as described below.

When is my Medicare enrollment period?

  • In most cases, if you receive SSA or RRB disability benefits, your Medicare Initial Enrollment Period (IEP) starts the 22nd month of receiving these benefits, continues through your qualifying month (the 25th month), and goes until the end of your 28th month of receiving benefits. That’s a total of seven months.
  • If you have to enroll in Medicare manually, you can begin the enrollment process anytime during your IEP.
  • If you have Lou Gehrig’s disease (ALS), your Medicare enrollment period may vary depending on your situation. Your enrollment should happen automatically if you receive disability benefits, but if you have questions you can contact Social Security (contact information below).
  • If you have end-stage renal disease (ESRD), again, your Medicare enrollment period may vary depending on your situation. Call Social Security for details (or the RRB if applicable – contact information for both agencies is below).

How to apply manually for Original Medicare

The Social Security Administration (or Railroad Retirement Board, if you worked for a railroad) handles Medicare enrollment. You can apply in any of the following ways.

  • Apply online at https://www.ssa.gov/forms/apply-for-benefits.html.
  • Call 1-800-772-1213 Monday through Friday between the hours of 7AM and 7PM to make an appointment. TTY users should call 1-800-325-0778.
  • Visit your local Security Service office.
  • If you worked for a railroad, contact the RRB or visit the agency’s website. Call 1-877-772-5772 (TTY users call 1-312-751-4701) Monday through Friday, 9AM to 3:30PM, to speak to an RRB representative.

When you’re signed up for Original Medicare, you may have other Medicare coverage options. Take a look at our Compare Medicare Plans page to learn more.

Medicare Advantage Plans, sometimes called "Part C" or "MA Plans," are offered by private companies approved by Medicare and provide Medicare Part A and Part B coverage. Medicare prescription drug coverage is insurance run by an insurance company or other private company approved by Medicare. A Medicare Supplement plan is a health insurance plan provided by a private company that fills in the "gaps" in original Medicare coverage.

Medicare has neither reviewed nor endorsed this information.

To learn about Medicare plans you may be eligible for, you can:

  • Contact the Medicare plan directly.
    • Call 1-800-MEDICARE (1-800-633-4227), TTY users 1-877-486-2048; 24 hours a day, 7 days a week.
  • Contact a licensed insurance agency such as PlanPrescriber's parent company, eHealth.
    • Call eHealth's licensed insurance agents at 888-323-1149, TTY users 711. We are available Mon - Fri, 8am - 8pm ET. You may receive a messaging service on weekends and holidays from February 15 through September 30. Please leave a message and your call will be returned the next business day.
    • Or enter your zip code where requested on this page to see quote.