You're automatically enrolled in Medicare Part A and Part B after you've been on SSDI for 24 months

If you receive Social Security Disability Insurance, you do not need to submit a separate Medicare process. The Social Security Administration handles this for you. After you have been on SSDI for exactly 24 months, Medicare Part A (hospital insurance) and Part B (medical insurance) begin automatically on the first day of the 25th month. You will receive a Medicare card in the mail before your coverage starts.

This automatic enrollment is one of the few times the government moves without requiring you to fill out forms. However, you still have choices to make about your coverage, and missing those choices can cost you money or leave gaps in your care.

Key Takeaways

  • Medicare Part A and Part B start automatically 24 months after your SSDI approval date, with no process needed on your part.
  • You will receive your Medicare card by mail before coverage begins, but you should verify the information on it as soon as it arrives.
  • You must choose a Part D prescription drug plan and a Part C (Medicare Advantage) or Medigap supplemental plan during your enrollment window, or you may face higher costs later.
  • If you turn 65 while on SSDI, your SSDI becomes Social Security retirement benefits, but your Medicare coverage continues without interruption.
  • Contact Social Security at 1-800-772-1213 to confirm your 24-month countdown or to report if you do not receive your Medicare card.

What happens during your 24-month waiting period

The 24 months begins on the date your SSDI claim is approved, not the date you applied or the date you became disabled. Social Security counts this period automatically—you do not need to do anything. During these 24 months, you are responsible for your own health insurance through an employer, the Affordable Care Act marketplace, Medicaid, or another source.

If you cannot afford private insurance during this period, you may be able to enroll in your state's Medicaid program. Medicaid rules vary by state, but many states cover working-age adults with disabilities at little or no cost. Contact your state Medicaid office or call 211 to find out whether you may have access to.

Some people on SSDI work and have employer health insurance during the waiting period. If that is your situation, you can keep that insurance even after Medicare starts. Having both Medicare and employer coverage is legal and sometimes useful, though you will pay premiums for both.

Your Medicare card and the information it contains

Your Medicare card will arrive by mail approximately two weeks before your coverage begins. The card shows your name, date of birth, sex, Medicare number, and the date each part of Medicare begins. Check this information carefully against your Social Security records. If any detail is wrong—especially your name or date of birth—contact Social Security when ready at 1-800-772-1213 to request a corrected card.

Your Medicare number is not the same as your Social Security number. Starting in 2020, Medicare numbers are random 11-digit numbers rather than SSNs. Keep your Medicare card in a safe place and bring it to every doctor's appointment. If you lose it, you can request a replacement online at Medicare.gov or by calling 1-800-MEDICARE.

Do not wait until your first doctor's appointment to check your card. If there are errors, correcting them takes time, and you do not want to discover a problem when you are trying to see a doctor.

Choosing Part D (prescription drug coverage) and supplemental plans

Medicare Part A and Part B are automatic, but Part D (prescription drug coverage) and supplemental coverage are not. You must make these choices during your enrollment window, which is the seven-month period that begins three months before your Medicare start date and ends three months after. If you do not choose a plan during this window, you may pay a permanent penalty on your premiums for as long as you have Medicare.

For Part D, compare plans on Medicare.gov or call 1-800-MEDICARE. Plans vary in which drugs they cover, what you pay at the pharmacy, and which pharmacies participate. If you take prescription medications, check whether your drugs are on each plan's formulary (the list of covered drugs) before you enroll. Some plans are free or low-cost for people with low incomes; ask whether you may have access to for the Low-Income Subsidy (LIS) program.

For supplemental coverage, you have two main paths: Medicare Advantage (Part C) or a Medigap policy. Medicare Advantage is an all-in-one plan that includes Part A, Part B, and usually Part D. Medigap is a separate policy that covers costs Medicare does not pay. The choice depends on your doctors, your medications, and your budget. If you have a preferred doctor or specialist, check whether they accept Medicare Advantage plans in your area before you enroll.

What changes when you turn 65 while on SSDI

When you reach full retirement age (which varies by birth year, ranging from 65 to 67), your SSDI automatically converts to Social Security retirement benefits. Your monthly payment may change slightly because the formulas for disability and retirement are different, but your Medicare coverage does not change. You stay on the same Part A and Part B, and your Part D and supplemental plans continue unless you cancel them.

You do not need to do anything when this conversion happens. Social Security handles it automatically and will send you a notice explaining the change. If you have questions about how the conversion affects your benefits, call Social Security at 1-800-772-1213.

If you do not receive your Medicare card or coverage does not start

Contact Social Security if your Medicare card does not arrive by the time your coverage is supposed to begin. Call 1-800-772-1213 and have your Social Security number ready. Social Security can confirm your 24-month countdown, verify that your Medicare enrollment was processed, and request a replacement card if needed.

If you have already received your card but your coverage does not work when you try to use it at a doctor's office or pharmacy, call 1-800-MEDICARE to report the problem. Medicare can check whether your coverage is active in their system and troubleshoot why the provider is not seeing it. Sometimes the delay is on the provider's end—their system has not updated yet—and sometimes it is a genuine enrollment error that needs to be fixed.

Keep records of when you called, whom you spoke with, and what they told you. If the problem is not resolved within a few days, call again and ask to speak with a supervisor.

How your SSDI and Medicare interact with work incentives

If you work while on SSDI, your earnings can affect your SSDI benefits, but they do not affect your Medicare coverage. Once you have been on SSDI for 24 months and Medicare begins, you keep Medicare even if your earnings later cause your SSDI to end. This is one of the strongest work incentives in the SSDI program: you can work, lose your cash benefit, and still have health insurance.

However, you will have to pay the standard Medicare Part B premium (currently around $165 per month, though this varies by income) once your SSDI ends. If your income is low, you may be able to get help paying this premium through your state Medicaid program. Contact your state Medicaid office to ask whether you may have access to for the may have access to Medicare Beneficiary (QMB) program or the Specified Low-Income Medicare Beneficiary (SLMB) program, both of which help cover Medicare premiums and cost-sharing.

Frequently Asked Questions

Can I enroll in Medicare before my 24 months are up?

No. Medicare enrollment is automatic at exactly 24 months and cannot be moved earlier. If you need health insurance before then, explore Medicaid in your state, the Affordable Care Act marketplace, or COBRA coverage if you recently left an employer plan. Some states also have programs for uninsured adults with disabilities.

What if I was already on Medicare when I got approved for SSDI?

If you were already receiving Social Security retirement benefits and Medicare when you switched to SSDI, your Medicare continues without interruption. Your SSDI approval does not restart the 24-month clock. You keep the same Medicare coverage you had before.

Do I have to pay premiums for Medicare Part A?

Most people on SSDI do not pay a Part A premium because they have enough work credits. However, if you do not have enough credits, you may have to pay a monthly premium. Social Security will tell you whether you owe a Part A premium when your Medicare starts. If you do owe it, the premium is deducted from your SSDI payment.

What happens to my Medicaid when Medicare starts?

This depends on your state. Some states automatically end Medicaid when Medicare begins; others continue it to help cover Medicare premiums and cost-sharing. Contact your state Medicaid office before your Medicare start date to find out what will happen to your coverage. You may be able to stay on Medicaid even after Medicare begins.

Can I change my Part D or supplemental plan after I enroll?

Yes, but only during the annual enrollment period (October 15 to December 7 each year) or if you have a may have access to life event like moving to a new state or losing other coverage. If you choose the wrong plan, you are stuck with it for a full year unless a may have access to event occurs. Choose carefully during your initial enrollment window.