Medicare Under 65 - Disability & ESRD Eligibility for Medicare Benefits

Anyone approved for Social Security Disability Insurance (SSDI) qualifies for Medicare under 65 automatically. Getting approved for SSDI itself is a long process, and even after approval, you generally wait 24 months before Medicare benefits start.

You can also qualify for Medicare after receiving Railroad Retirement Board benefits for 24 months. Either path requires that you've qualified for Social Security benefits yourself, or that you're the spouse or dependent child of someone who has.

You can get Medicare at any age if you have End-Stage Renal Disease, permanent kidney damage that may require dialysis or a transplant. Before coverage starts, you need to meet one of the following:

• You qualify for Social Security or Railroad Retirement benefits.
• You've worked the required amount of time under Social Security or the Railroad Retirement Board.
• You're the spouse or dependent child of someone who meets either of the above.

If you're on dialysis, coverage usually begins the first day of the fourth month of treatment. Medicare enrollment isn't automatic in this case, even once you qualify, so you'll need to contact Social Security directly to enroll.

If you have ALS (Lou Gehrig's disease), you qualify for Medicare automatically the month your Social Security or Railroad Retirement Board disability benefits start, with no waiting period. Because ALS is progressive and often requires support for nutrition, breathing, and mobility, coverage is generally in place for the rest of your life once it begins.

If you're under 65 and don't qualify through disability, ESRD, or ALS, an ACA Marketplace plan can bridge the gap until your Medicare eligibility begins.