Medicare and People with Disabilities

Medicare is another medical benefit for people with disabilities who qualify for Social Security Disability Insurance (SSDI). The Social Security Administration (SSA) and Centers for Medicare & Medicaid Services follow certain guidelines for people with disabilities and others eligible for Medicare. Here are 15 facts you should know about Medicare plans.


  1. Most Americans become eligible for Medicare, a federally funded healthcare program when they reach age 65.
  2. Medicare’s age eligibility requirement does not apply to people with certain disabilities who are unable to work and qualify for SSDI.
  3. After people with disabilities receive cash Social Security disability benefits, there is a 24-month waiting period before they can receive Medicare. However, certain medical conditions can reduce or eliminate the waiting period.
  4. Those who have Lou Gehrig’s disease, or Amyotrophic Lateral Sclerosis (ALS), qualify for Medicare as soon as they are approved for Social Security disability benefits.
  5. Someone who has an end-stage renal disease (ESRD) can become immediately eligible for Medicare, without an age limitation or waiting period.
  6. Medicare comprises four key components: Parts A, B, C, and D.
  7. Medicare Part A provides hospitalization benefits. Medicare Part B covers medically necessary treatments, durable medical equipment (DME) and several preventive services. Examples of preventive services include screenings for cardiovascular impairments, diabetes, colon cancer, glaucoma, and HIV. In addition, mammograms, and prostate and pelvic examinations are covered.
  8. Medical services provided under Part B include services such as flu shots, medical nutrition therapy, pneumonia vaccines and bone mass measurements.
  9. Medicare Part C plans are known as Medicare Advantage (MA) plans. Part C includes all of the benefits of Medicare Parts A and B, and usually Part D, which is prescription drug coverage. However, Medicare enrollees should always compare the inclusions, exclusions and prescription limits of these plans to ensure the plan meets their health and financial needs.
  10. Under Medicare Part B, benefits also include durable medical equipment (DME) and prosthetics. And Medicare Part D covers prescriptions. It’s critical to review the terms provided under someone’s chosen plan or plans every year, especially during annual open enrollment, since they are subject to change.
  11. Each year, the federal government, the Centers for Medicare & Medicaid Services and the Social Security Administration (SSA) announce policy and program changes for Medicare recipients and people with disabilities. So it’s important to stay informed about these updates, and consider turning to Medicare and Social Security experts for assistance.
  12. Medicare Parts A and B are sometimes referred to as “Original Medicare” or “Traditional Medicare.”
  13. Even though Medicare Parts A and B cover a large number of healthcare services, some people with disabilities and others opt to purchase a Medigap plan. Medigap plans provide supplemental insurance that covers expenditures not covered by Medicare Parts A and B and are available to people under the age of 65 only in certain states.
  14. Subsequent to the general enrollment period, Medicare benefits become effective on the first day of one’s birthday month, or the previous month when the birth date falls on the first day of the month.
  15. People with disabilities and seniors eligible for Medicare do not have to struggle through the complex program alone. Some national organizations provide professional, unbiased guidance for determining whether original Medicare with a Part D plan or a Medicare Advantage plan will better meet the person’s needs.