Medicare Coverage for People with Disabilities
There is available Medicare for certain people with disabilities under the age of 65. These people must have received social security benefits for 24 months, or have amyotrophic lateral sclerosis (ALS, also known as Lou Gehrig’s disease), or end-stage renal disease (ESRD). There will be a waiting period of five months after a beneficiary is considered disabled before a beneficiary benefits from social benefits for the disabled. People with ALS and ESRD, unlike those with other disability causes, do not have to earn benefits for 24 months to qualify for Medicare.
The eligibility requirements for Medicare for people with ALS and ESRD include:
- ALS – Immediately after enrolling for social security benefits for the disabled.
- ESRD: usually 3 months after starting regular dialysis or after a kidney transplant
People who meet all of the social security disability criteria are usually automatically included in Part A and Part B. Individuals who meet the standards, but do not receive social benefits, can enroll for Medicare by paying a monthly premium for the Part A in addition to the monthly Premium for Part B.
HOW TO APPLY for Medicare if disabled?
Persons entitled to disability benefits must receive a Medicare card by mail when the required time has elapsed. If this is not the case or if you have other questions, contact the Social Security Office.
What Are The Available Medicare Benefits For People With Disabilities?
Medicare coverage is the same for persons who are eligible due to disability as it is for people who qualify due to their age. For beneficiaries, the full Medicare 2019 supplement benefits are available. The coverage includes certain nursing homes, hospitals, home health services, doctors and community services. Health services do not have to be related to the person’s disability to get insurance.
People with mental illness, dementia, and other chronic and long-term conditions can achieve coverage. There are no diseases or basic conditions that disqualify individuals for Medicare insurance. The beneficiaries have the right to an individualized evaluation of whether they meet the collection criteria.
While there are criteria that must be met to access certain types of care, Medicare should not be rejected because of the person’s underlying illness, diagnosis or other “general rules.” For instance:
- Coverage should not be denied to beneficiaries simply because they need long-term medical care.
- Coverage should not be denied to beneficiaries because their underlying situation may not improve.
- Beneficiaries should not be denied coverage simply because services are “just for maintenance” or because the patient has a certain condition or disease.
Physiotherapy and other services can be covered, although it is expected that the person’s condition will only be maintained or decrease deterioration, but not to improve it.
People with certain conditions are particularly vulnerable because they were unfairly denied access to Medicare coverage for the needed medical care.
People with these conditions and other long-term conditions qualify for coverage if the care ordered by their doctors meets the Medicare criteria:
- Mental illness
- Alzheimer disease
- Parkinson’s disease
- multiple sclerosis
If Medicare registration or coverage has been improperly denied, ask your doctor for help.