Under 65 and qualify for Medicare due to a disability?

Under 65 and qualify for Medicare due to a disability?

Under 65 and qualify for Medicare due to a disability or ESRD?

Having a physical disability can be a stressful situation. Medicare has established health insurance for those under 65 and unable to work. Programs are in place for those that have begun receiving Social Security benefits for a period of 24 months (in some cases shorter). It can be a difficult process to understand and qualify for, but if done correctly, the financial stress that comes with not being able to work can be taken care of in part by Medicare.


To qualify for Medicare being under 65, there are certain conditions that must be met. Upon becoming disabled, Social Security will begin to pay benefits. After a period of 24 months, you then can qualify for Medicare hospital insurance and insurance for doctor visits as well. Part D insurance is also optional, and will cover prescription drug costs. In some cases you may have an option to get a Medigap policy. Medigap policies help pay the gaps not covered by Medicare. Learn more about Medigap policies here.

Parts of Medicare and What They Cover

Part A

Medicare Part A is “Hospital Insurance”, it helps cover:

  • Inpatient care services
  • Inpatient care in a skilled nursing facility(not custodial or long-term care)
  • Hospice care services
  • Home health care services

Medicare part A coverage does have limits, such as deductibles and limits on the period of time you can stay at a hospital or other facilities. Although there is a small cost, Medicare coverage still covers a majority of the cost of hospital visits and nursing facilities. Medigap insurance can pay some or all of these costs.

Part B

Medicare Part B is “Medical Insurance”, it helps cover:

  • Medically-necessary doctor services
  • Outpatient care
  • Home health services
  • Durable medical equipment
  • Also some other medical services

Being disabled, this will help cover the cost of visiting specialists and attending therapy sessions (as long as it is Medicare approved). There is a monthly premium for part B coverage, and this will be deducted from your monthly social security check.

Part D

Part D covers prescription drugs, and is another advantageous part of Medicare for disabled people. Premiums and requirements vary by state, and some investigation may be required for the requirements in the state that you live in.

Getting the Most out of Medicare

Being under 65 doesn’t mean that you aren’t entitled to the benefits that Medicare offers. The way to maximize coverage is to fully understand the benefits you are entitled to and stay up to date with deadlines and application procedures. If you need frequent doctor’s visits or prescription medications, consider a Medigap policy to cover what Medicare doesn’t. Medigap policy requirements vary by state and by company, so more investigation will be required to choose an effective plan to fit your needs. Another point to keep in mind is that not all parts of Medicare may be necessary. Part B and D are optional, so it’s best to customize a healthcare plan that will efficiently cover you during your time of disability.

Our agency helps you understand the different types of Medigap plans & options available to you in your specific state. We will compare and explain each plan along with giving you quote details on the carries in your area. If you would like to speak with a specialist about your options or to get a better understanding of Medicare and Medigap insurance please give us a call at (855) 321-3210. If you are just looking for a quote comparison please fill out the form on this page and one will be available to you.   


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