How to Get Medicare If You’re Under 65: A Complete Guide

Who Qualifies for Medicare Before 65?

There are three main ways you can qualify for Medicare before age 65:

1. Social Security Disability Insurance (SSDI)

If you’ve been receiving SSDI payments for at least 24 months, you automatically qualify for Medicare. However, there is a two-year waiting period before your coverage begins. This means that your Medicare benefits start in the 25th month after you first receive SSDI payments.

2. End-Stage Renal Disease (ESRD)

If you have End-Stage Renal Disease (ESRD), meaning your kidneys have failed and you need dialysis or a kidney transplant, you do not have to wait two years. Medicare coverage typically starts within three months of beginning dialysis or immediately after a kidney transplant.

3. Amyotrophic Lateral Sclerosis (ALS)

If you’ve been diagnosed with ALS (Lou Gehrig’s Disease), you automatically qualify for Medicare as soon as you start receiving SSDI benefits, with no waiting period.

Understanding the 24-Month Waiting Period for SSDI Recipients

If you qualify for Medicare through SSDI, you need to be aware of the two-year waiting period. It starts from the first month you receive SSDI payments, not the date of approval.

Are There Any Exceptions?

Yes! If you qualify for Medicare due to ESRD or ALS, you can bypass this waiting period and get coverage sooner.

How to Get Coverage During the Waiting Period

One of the biggest concerns during this waiting period is maintaining health insurance coverage. Here are some options:

• COBRA Coverage – You might be able to continue your employer-sponsored health insurance through COBRA, though it can be expensive.
• Affordable Care Act (ACA) Marketplace Plans – These plans can offer a more affordable way to stay covered while waiting for Medicare.
• State Medicaid Programs – If you have limited income, you may qualify for Medicaid, which can provide health coverage during the waiting period.

If you need help finding coverage, give us a call at 800-208-4974. Our team is happy to assist you!

What Medicare Covers If You’re Under 65

Once you become eligible, you receive the same Medicare benefits as those enrolling at 65. This includes:

• Medicare Part A – Covers hospital stays, skilled nursing facilities, and hospice care.
• Medicare Part B – Covers doctor visits, outpatient care, medical equipment, and preventive services.
• Medicare Part D – Optional prescription drug coverage.

Medicare Supplement (Medigap) Plans for Those Under 65

There is one key difference for those enrolling in Medicare before age 65: Medicare Supplement (Medigap) plans may not be available in all states. Even when they are, premiums can be significantly higher than for those who enroll at 65.

Medicare Advantage Plans (Part C) as an Alternative

If Medigap plans are not an option or are too expensive, a Medicare Advantage (Part C) plan could be a great alternative. These plans:

• Combine hospital, medical, and prescription drug coverage into one plan.
• Often include extra benefits like dental, vision, hearing, and fitness programs.
• Take over as your primary insurance instead of Original Medicare.

If you want to compare Medicare Advantage plans, call us at 800-208-4974 to book a free consultation.

What Happens When You Turn 65?

If you’re already on Medicare before 65, you get a new enrollment period when you turn 65. This is great news because:

• You can purchase a Medigap plan without health questions or medical underwriting.
• Your premiums will be lower than if you had enrolled in Medigap before 65.
• You have the opportunity to reevaluate your coverage to make sure you’re on the best plan for your needs.

Key Takeaways

• You can qualify for Medicare before 65 if you’ve been on SSDI for 24 months, have ESRD, or have ALS.
• If you qualify through SSDI, there is a two-year waiting period before Medicare coverage starts.
• Medicare Supplement (Medigap) plans may have limited availability or higher costs for those under 65.
• Medicare Advantage (Part C) plans can be a great alternative, offering additional benefits and often lower costs.
• When you turn 65, you get a new enrollment period with better Medigap options and standard pricing.

Get Expert Help with Your Medicare Plan

Navigating Medicare before 65 can be complicated, and choosing the wrong plan could cost you thousands of dollars. That’s why we specialize in helping people like you find the best Medicare coverage for their needs. Call us today at 800-208-4974.

Our services are 100% free, and we’ll make sure you get the best possible coverage for your situation.