Medicare was first envisioned as a federal benefits program for everyone, but by the time the Medicare and Medicaid Act was signed into law by President Johnson in 1965, Medicare was designated to provide benefits to Americans age 65 and older. Although seniors are the largest demographic to use Medicare these days, you may be surprised to learn that Medicare isn’t just health insurance for seniors.
You can receive Medicare benefits if you are under the age of 65; however, there are a number of stipulations. Additionally, Medicare eligibility under the age of 65 also means that you will need to remain qualified to continue receiving benefits. If you’ve qualified for Medicare by reaching age 65, you obviously can’t turn back time and become disqualified. You can, however, lose your Medicare benefits if you lose your status as qualified for Medicare under 65.
How Can I Qualify for Medicare Before I’m 65?
In order to obtain Medicare eligibility under 65, you need to meet certain disability requirements as defined by the Social Security Administration. This means that your disability will need to qualify you for Social Security Disability Insurance (SSDI), so not just any disability will count. You may be disabled according to your standards or even some medical opinions, but until the Social Security Administration qualifies you and you receive SSDI, Medicare will not consider you for benefits under the age of 65.
Additionally, even after being qualified as disabled and receiving SSDI payments, you will need to wait 24 months from the date of your first SSDI payment to enroll in Medicare under the age of 65. If you are somehow found to be disqualified from disability payments in the future, you will no longer be eligible for Medicare through Social Security. Instead, you will need to wait until you reach age 65. This may be the case when someone is qualified as disabled, receives benefits and then is cured of the condition causing disability.
Special Considerations for End-Stage Renal Disease
End-stage renal disease (ESRD) can qualify you for Medicare regardless of age and regardless of SSDI status in some cases. In order to qualify for Medicare under 65 with ESRD, you will need to have undergone a kidney transplant, underwent or are currently undergoing dialysis or you or a spouse will have needed to have contributed enough to Medicare through paycheck deductions to qualify early for Medicare.
Medicare eligibility under 65 for those with ESRD is often examined on a case-by-case basis. If you qualify, Medicare Part A will extend retroactively for 12 months, meaning treatment you’ve sought in the past year should be covered as long as it falls within Medicare’s guidelines under the program’s inpatient benefits.
Are Medicare Benefits Different for People Under 65?
If you qualify for Medicare benefits under 65, you will still have access to the same coverage provided to Medicare recipients over the age of 65. These benefits include Medicare Part A (hospital insurance), Medicare Part B (medical insurance) and Medicare Part D (prescription drug coverage).
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