People who are found disabled by the Social Security Administration, and entitled to Social Security Disability Insurance (SSDI) benefits, automatically qualify for Medicare coverage, but there is a catch. Although many people will qualify for Medicare coverage immediately, some do not because Social Security has a waiting period before coverage kicks in.
The 24-month waiting period begins when an SSDI beneficiary is first entitled to benefits. Not only is there a Medicare waiting period, but also an SSDI waiting period which makes beneficiaries wait an additional five months before they are first entitled to benefits, from the date they are found disabled. This is typically quite confusing for people going through this process, so trying to explain it a bit more clearly would benefit many people going through the process.
Example
John has received verification that he is disabled and entitled to SSDI benefits. The date John was found disabled was January 1, 2016. John has to wait five months before he is first entitled to an SSDI payment, which would be June 1, 2016. This is when his retroactive benefits would kick-in. Beginning in March of 2018, John will receive his first monthly SSDI payment, and the months previous, in which he was entitled to benefits going back to June 2016, would be paid retroactively in a lump sum payment. Because John was first entitled to benefits in June 1, 2016 he would still have to wait until June 2018 to be covered by Medicare, which would satisfy Medicare’s 24-month waiting period from the date John was first entitled to SSDI benefits.
Exceptions
Some conditions and impairments are considered so severe and life-threatening that Social Security waives the waiting period for Medicare coverage for some people. The two types of impairments that automatically call for the waiving of the waiting period are:
- Amyotrophic Lateral Sclerosis (ALS), sometimes better know as Lou Gehrig’s disease; and
- End-stage renal disease or kidney failure.
