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Purple··4 min read

What Is Medicare and How Does It Work with SSDI?

If you receive SSDI, you'll eventually qualify for Medicare—but there's a waiting period. Here's everything you need to know about Medicare and SSDI.

In this article, we'll cover:

  1. What Medicare is
  2. The 24-month waiting period
  3. Medicare parts explained
  4. Costs and coverage

1. What Medicare Is

The basics:

  • Federal health insurance program
  • Originally for people 65+
  • Also for people on SSDI after waiting period
  • Also for people with certain conditions (ALS, ESRD)

How it differs from Medicaid:

  • Medicare: Earned through work history
  • Medicaid: Need-based
  • Medicare has premiums and co-pays
  • Can have both (dual eligible)

The parts:

  • Part A: Hospital insurance
  • Part B: Medical insurance
  • Part C: Medicare Advantage (alternative)
  • Part D: Prescription drugs

2. The 24-Month Waiting Period

How it works:

  • Must receive SSDI for 24 months
  • Waiting period starts with SSDI eligibility
  • Not from application date
  • Not from approval date

Counting the months:

  • Start from your "established onset date"
  • Add the 5-month SSDI waiting period
  • Then 24 months after SSDI payments begin
  • Total: 29 months from onset to Medicare

Example:

  • Disability onset: January 2024
  • 5-month SSDI wait: June 2024 first payment
  • 24 months from June 2024
  • Medicare starts: June 2026

Exceptions:

  • ALS (Lou Gehrig's disease): No waiting period
  • End-Stage Renal Disease (ESRD): Starts after dialysis begins
  • These conditions have special rules

Important: The 24-month wait can be challenging. Explore Medicaid, COBRA, or marketplace options in the meantime.

3. Medicare Parts Explained

Part A (Hospital Insurance):

  • Inpatient hospital care
  • Skilled nursing facility
  • Hospice care
  • Some home health care
  • Usually premium-free

Part B (Medical Insurance):

  • Doctor visits
  • Outpatient care
  • Preventive services
  • Medical equipment
  • Monthly premium required

Part C (Medicare Advantage):

  • Alternative to Parts A & B
  • Offered by private insurers
  • May include drug coverage
  • May have additional benefits
  • Network restrictions apply

Part D (Prescription Drugs):

  • Prescription coverage
  • Offered by private insurers
  • Separate premium
  • Various plan options
  • Must enroll when eligible

4. Costs and Coverage

2026 costs (estimated):

  • Part A: Usually $0 (if enough work credits)
  • Part B: ~$174.70/month (can be higher based on income)
  • Part D: Varies by plan
  • Co-pays and deductibles apply

What's covered by Part A:

  • Hospital stays (after deductible)
  • Skilled nursing (up to 100 days)
  • Home health care
  • Hospice care

What's covered by Part B:

  • Doctor services
  • Outpatient procedures
  • Lab tests
  • Preventive care
  • Durable medical equipment

What's NOT covered:

  • Long-term care
  • Most dental care
  • Eye exams for glasses
  • Hearing aids
  • Routine foot care

Filling the gaps:

  • Medigap (supplemental insurance)
  • Medicare Advantage plans
  • Medicaid (if eligible)
  • Employer coverage

Managing Medicare Costs

Low-Income Subsidies:

  • Extra Help with Part D
  • Medicare Savings Programs
  • Reduced premiums and co-pays
  • Based on income and resources

If you have both SSI and SSDI:

  • May qualify for Medicaid
  • Medicaid can pay Medicare premiums
  • Called "dual eligible"
  • Best of both programs

Premium deduction:

  • Part B premium usually deducted from SSDI
  • Reduces your net payment
  • Shows on benefit statement
  • Automatic enrollment

During the Waiting Period

Healthcare options:

  • Medicaid (if you qualify by income)
  • COBRA (expensive but comprehensive)
  • Marketplace plans (may qualify for subsidies)
  • State high-risk pools
  • Community health centers

Don't go without coverage:

  • 24 months is a long time
  • Medical emergencies happen
  • Explore all options
  • Healthcare.gov may help

How Purple Helps

  • Track SSDI payments
  • See Medicare premium deductions
  • Understand your net benefit
  • Clear payment history
  • Early access to deposits

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