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Can I Be Eligible for Medicare if I Am Under 65?

Medicare eligibility was originally determined by age; the Medicare age was 65 and over when Medicare was established in 1965. The Medicare age is still 65 and over; however, since 1973, Medicare has also been available to people under age 65 who receive Social Security Disability Insurance (SSDI). People with specific health conditions including Lou Gehrig’s disease (ALS) and end-stage renal disease (ESRD) also generally have Medicare eligibility under the age of 65.

However, certain kinds of Medicare coverage, including a Medicare Supplement plan, may not be available to you if you are eligible for Medicare under 65. Medicare Supplement plans cover some Medicare out of pocket costs including copayments, coinsurance and deductibles. Federal law doesn’t require insurance companies to sell Medicare Supplement plans to people under 65. Note that in some states you may be able to buy certain Medicare Supplement plans if you are under 65 and have Medicare eligibility.

How can I get Medicare eligibility under 65 with a disability?

If you haven’t reached the Medicare age of 65, you may still have Medicare eligibility with a disability. You may get Medicare Part A (hospital insurance) and Part B (medical insurance) after you’ve received Social Security disability benefits for 24 months or certain disability benefits from the Railroad Retirement Board for 24 months. Certain medical conditions explained below may qualify you for a waiver from this two year waiting period.

If you have Medicare eligibility by disability you can also opt to enroll in a Medicare Advantage plan (Part C) offered by a private insurance company. Medicare Advantage plans must cover everything that Original Medicare (Part A and Part B) cover and many plans offer additional benefits as well. For prescription drug coverage, you may enroll in Medicare Part D, either through a stand-alone plan to go alongside Original Medicare or a Medicare Advantage plan that includes prescription drug coverage.

How can I get Medicare under 65 with ESRD?

You can get Medicare at any age if your kidneys no longer work and you need regular dialysis or have had a kidney transplant.

In addition, you can get Medicare if you:

  • have worked a required time
  • are eligible for Social Security or Railroad Retirement benefits
  • or are the spouse or dependent child of someone who has worked the required time or is eligible for Social Security or Railroad Retirement Board benefits.

If you enroll in Medicare and you’re on dialysis, your Medicare coverage will usually start on the first day of the fourth month of your dialysis treatments. There is generally no 24-month waiting period as there is with other disabilities.

How can I get Medicare under 65 with ALS?

According to the ALS Association, the average age that people receive an ALS diagnosis is 55. This means that most people with ALS are diagnosed before they reach the Medicare age of 65. The good news is that if you have Amyotrophic Lateral Sclerosis (ALS) you can automatically get Medicare Part A (hospital insurance) and Medicare Part B (medical insurance) the month your Social Security or Railroad Retirement Board disability benefits begin. If you have Medicare eligibility because of ALS, you will generally be eligible for Medicare for the rest of your life.

Can I get Medicare eligibility under 65 for another reason?

Generally, severe disability and specific serious health conditions are the only ways to get Medicare eligibility under 65. If you are looking for government health insurance because you have low income, you can apply to Medicaid.

To learn more about a Medicare plan you may be eligible for, enter your zip code on this page.

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