How To Apply For Medicare When You Receive SSDI

You do not explore for Medicare separately if you receive SSDI

Medicare enrollment happens automatically once you have been receiving SSDI payments for 24 months. You do not fill out a Medicare process form or contact Medicare to request it. Social Security handles the enrollment in the background, and Medicare coverage begins on the 25th month of your SSDI payments.

The only exception is if you are under 65 and receiving SSDI because of end-stage renal disease (ESRD) or amyotrophic lateral sclerosis (ALS). In those cases, Medicare coverage can begin earlier — after three months of SSDI payments for ESRD, or when ready upon approval for ALS. If either condition applies to you, Social Security will contact you about your Medicare start date.

Because enrollment is automatic, many people do not realize they have Medicare until they receive their Medicare card in the mail. That card typically arrives about a month before your coverage begins, but you can check your status online or by phone before it arrives.

Key Takeaways

Medicare enrollment is automatic after 24 months of SSDI payments; you do not need to submit an process or contact Medicare.
Your Medicare card will arrive by mail roughly one month before your coverage starts, but you can verify your enrollment status through your Social Security account or by calling Social Security.
If you have end-stage renal disease or ALS, Medicare may begin sooner than 24 months, and Social Security will notify you of the exact date.
Medicare Part A (hospital insurance) and Part B (medical insurance) are both included in automatic enrollment; you can decline Part B if you choose, but most people keep it.

How to check if your Medicare enrollment has started

You can verify your Medicare status before your card arrives. The fastest way is to create or log into your my Social Security account at ssa.gov. Once logged in, go to "Benefit Verification" and look for a section showing your Medicare status. If you have been receiving SSDI for 24 months or more, it will show your Medicare coverage start date.

If you do not have a my Social Security account, you can call Social Security directly at 1-800-772-1213 (TTY 1-800-325-0778). Have your Social Security number ready. Tell them you want to confirm your Medicare enrollment status. They will tell you whether Medicare has started and when your card should arrive.

You can also call Medicare directly at 1-800-MEDICARE (1-800-633-4227) to confirm your enrollment. They can look up your information by Social Security number and tell you your coverage start date and what parts of Medicare you are enrolled in.

What Medicare parts you receive and what they cover

Automatic enrollment includes both Part A and Part B. Part A covers hospital stays, skilled nursing facility care, hospice, and some home health services. Part B covers doctor visits, outpatient care, medical equipment, and preventive services. You pay no monthly premium for Part A. Part B has a monthly premium that is deducted from your SSDI payment.

The Part B premium amount changes each year. For 2024, the standard premium is $164.90 per month, but your actual premium may be higher or lower depending on your income. If your income is above a certain threshold, you may pay an additional amount called an Income-Related Monthly Adjustment Amount (IRMAA). Social Security will tell you your exact premium when you receive your Medicare card.

You are not automatically enrolled in Part D (prescription drug coverage) or Part C (Medicare Advantage plans). You can choose to enroll in either of these during the annual enrollment period (October 15 to December 7 each year), or you can use Original Medicare (Part A and Part B) without them. If you do not enroll in Part D when you first become may be able to access and you go without drug coverage, you may pay a penalty later if you enroll.

What to do if you do not receive your Medicare card

Medicare cards are mailed about one month before your coverage starts. If your coverage start date has passed and you have not received your card after two weeks, contact Social Security first. Your address on file may be incorrect, or the card may have been lost in the mail.

Call Social Security at 1-800-772-1213 and confirm your mailing address. If the address is correct, ask them to request a replacement card. You can also update your address through your my Social Security account online. After updating, allow 7 to 10 business days for a new card to be mailed.

While you wait for your card, you can still use Medicare. Ask your doctor's office or hospital to look up your Medicare number using your Social Security number. You can also call Medicare at 1-800-MEDICARE and they will provide your Medicare number over the phone. Use that number when scheduling appointments or paying medical bills.

How to decline Part B if you do not want it

Part B is included in automatic enrollment, but you can refuse it if you choose. This is rare, because Part B covers essential services and the premium is usually modest compared to the cost of medical care. However, if you have other health insurance through an employer or a family member, you might not need Part B.

To decline Part B, you must do so within a specific window. You have until the end of the month in which your Part B coverage would start, or the end of the following month, whichever is later. For example, if your Medicare starts on the 25th of a month, you have until the end of the next month to decline.

Contact Social Security in writing to decline Part B. You can mail a letter to your local Social Security office, or call 1-800-772-1213 and ask them to mail you a form to sign. Keep a copy of any letter or form you submit. If you decline Part B and later change your mind, you can enroll during the annual enrollment period, but you may owe a penalty for the months you were not covered.

What happens to your Medicaid when Medicare starts

If you were receiving Medicaid before Medicare began, the two programs work together. Medicare becomes your primary insurance, and Medicaid becomes secondary. This means Medicare pays first for covered services, and Medicaid may cover costs that Medicare does not pay, such as copayments and deductibles.

You do not lose Medicaid when Medicare starts. However, your Medicaid coverage may change depending on your state's rules. Some states automatically adjust your Medicaid when Medicare begins; others require you to report the change. Contact your state Medicaid office to confirm your coverage continues. You can find your state Medicaid office through medicaid.gov.

If you live in a state with a Medicaid program for people with both Medicare and Medicaid (called Medicaid Buy-In or Working Disabled programs), your may be able to access may change once Medicare starts. These programs have different income and resource limits. Your state Medicaid office will contact you if your coverage changes, but it is worth calling them to confirm.

Frequently Asked Questions

What if I have been receiving SSDI for less than 24 months — can I get Medicare early?

No, unless you have end-stage renal disease or ALS. For all other disabilities, Medicare begins automatically after exactly 24 months of SSDI payments. If you need health coverage before then, you may be able to keep Medicaid or purchase a plan through the health insurance marketplace.

Do I have to pay for Medicare if I am on SSDI?

Part A (hospital insurance) is free. Part B (medical insurance) has a monthly premium that Social Security deducts from your SSDI payment. The 2024 standard premium is $164.90 per month, though yours may be different based on your income. You do not pay anything out of pocket — it comes directly from your benefit.

What if my Medicare card shows the wrong information?

Call Medicare at 1-800-MEDICARE and report the error. They can correct your name, date of birth, or other details. You can also contact Social Security, since they manage the enrollment. Corrections usually take 7 to 10 business days, and a corrected card will be mailed to you.

Can I switch to a Medicare Advantage plan (Part C) after I enroll?

Yes. You can enroll in a Medicare Advantage plan during the annual enrollment period (October 15 to December 7) or during the Medicare Advantage Open Enrollment Period (January 1 to March 31). You can also switch back to Original Medicare during these same windows. Call 1-800-MEDICARE for a list of plans available in your area.

What if I move to a different state after Medicare starts?

Your Medicare coverage continues regardless of where you live. However, your Medicaid coverage may change because each state runs its own program. Contact your new state's Medicaid office to report your move and confirm your coverage. Your Medicare coverage needs no action on your part.

This guide is for general information only and is not medical, financial, legal, or other professional advice. For decisions specific to your situation, consult a qualified professional. See our Editorial Policy.