Am I entitled to Medicare While Receiving Social Security Disability Insurance Benefits?

Possibly, but there's a waiting period before you're eligible. This is usually two years after the date of your entitlement to Social Security Disability Insurance (SSDI) benefits.

Here’s how this can work:

  • If your application for disability is approved, there's a five-month waiting period before you would be eligible for SSDI benefits. The date you qualify for payments is your entitlement date, and the two-year waiting period for Medicare starts from that date.
  • If you must appeal a denial of your application and win, a determination will be made as to the date of your entitlement to SSDI benefits, which may be retroactive. You would become eligible for Medicare two years after this date of entitlement.

What Medicare Benefits Can You Receive? Receiving medicare and SSDI

Medicare is broken down into four parts: A, B, C, and D. Once you receive SSDI benefits and become eligible for Medicare, you're automatically enrolled in Medicare, but may have to pay for portions of your coverage.

Here's what each part covers and the cost to you:

  • Part A. Part A pays for hospital expenses and some medical and hospice costs. You shouldn't have to pay premiums for this coverage.
  • Part B. This pays for doctor appointments and medical services and supplies not covered under Part A. You'll most likely be required to pay a premium for Medicare Part B. You have the right to opt out of coverage. However, if you later change your mind, it will cost you more to enroll.
  • Part C. Plan C is insurance policies offered by private companies approved by Medicare. They're often referred to as Medicare Advantage plans. You would need to pay premiums for Plan C.
  • Part D. Medicare Part D pays your prescription costs, and you would owe a premium for this coverage. Like Part B, you'll pay higher costs if you don't enroll in Part D when you become eligible for Medicare.

Do you have other questions regarding your SSDI claim? Call our office to schedule a free consultation with our experienced Social Security lawyers today.