You do not have to be 65 to sign up for Medicare. You could have a disability instead. As many as 14% of Medicare recipients qualify this way. Specifically, you could be someone on Social Security Disability Insurance (SSDI).
What Is a Disability?
The ADA (Americans with Disabilities Act) defines a person with a disability as a person who has a physical or mental impairment that substantially limits one or more major life activity. This includes people who have a record of such an impairment, even if they do not currently have a disability. It also includes individuals who do not have a disability but are regarded as having a disability.
The ADA National Network
Even using this definition, trying to pigeonhole disability can be fraught with controversy. Many people have impairments you can’t see. Others may technically have a physical handicap you CAN see but it doesn’t limit their function in any way. Look at the Paralympics!
It is important to not let an ableist view let you make assumptions about what someone can and cannot do.
Social Security Disability Insurance (SSDI)
Social Security Disability Insurance is very strict in its definition of disability. Because they will be providing you with a source of income, they base your eligibility on your ability to work in gainful employment.
They break your eligibility down into five questions:
- Is your condition on their list of disabling conditions (see lists in the References section)?
- Is your condition “severe” enough?
- Are you working now?
- Can you do the work you did before?
- Is there other work you can do despite your disability?
Even if your disability meets these criteria, you may not qualify for SSDI if you have not paid enough in Social Security taxes. You have to earn enough work credits to qualify and this number changes based on how old you are when you apply. People under 24 need at least 6 work credits within 3 years of their application and someone over 31 needs at least 20 work credits within 10 years. There is a gradated scale between 24 and 31 years old.
The value of a work credit changes every year. You earn one work credit for every $1,510 you work in FICA taxed-employment in 2022. Even if you earn more in income, you are allowed a maximum of 4 work credits per year.
Medicare Eligibility Based on SSDI
Timing is everything when it comes to getting Medicare on Social Security Disability. That’s because there are a number of waiting periods.
Application Process: First things first, you have to get your application approved. Social Security estimates that could take three to five months. If your application is initially denied, you may need to go through a reconsideration process that will take longer.
SSDI Waiting Period: Once your application is approved, there is a five-month waiting period before your SSDI benefits kick in.*
Medicare Waiting Period: Finally, you are not eligible for Medicare until your 25th month of SSDI benefits.*
*Amyotrophic lateral sclerosis (ALS) is the exception to the rule.
All in all, a disability may qualify you for Medicare but it’s going to take you a while to get coverage. Make sure you have access to other health care in the meantime.
References
Benefits Planner | Social Security Credits and Benefit Eligibility. (2022). SSA.gov. https://www.ssa.gov/benefits/retirement/planner/credits.html
How You Qualify | Disability Benefits. (2022). SSA.gov. https://www.ssa.gov/benefits/disability/qualify.html
Listing of Impairments – Adult Listings (Part A). (2022). SSA.gov. https://www.ssa.gov/disability/professionals/bluebook/AdultListings.htm
A Snapshot of Sources of Coverage Among Medicare Beneficiaries in 2018. (2021). KFF. https://www.kff.org/medicare/issue-brief/a-snapshot-of-sources-of-coverage-among-medicare-beneficiaries-in-2018/
What is the definition of disability under the ADA? | ADA National Network. (2022). Adata.org. https://adata.org/faq/what-definition-disability-under-ada
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