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How Having a Disability Affects Your Medicare Enrollment

If you have a disability or certain chronic health conditions such as Lou Gehrig’s Disease (ALS) or end-stage renal disease (ESRD), you may be eligible to complete your Medicare enrollment early, select from a different range of plans, and receive additional financial assistance. Read on to learn more about your options.

Medicare enrollment before age 65

Medicare eligibility often begins at age 65, and individuals may have to apply to enroll in Medicare Parts A and B. However, if you receive disability benefits from the Social Security Administration (SSA), you’ll be automatically enrolled in Medicare Parts A and B (Original Medicare) when you have received those benefits for two years, regardless of age.

Once you’ve been enrolled in Original Medicare, you also have the option to enroll in a prescription drug plan (Part D) or a Medicare Advantage Plan, some of which bundle Parts A, B, and D with additional benefits.

Eligibility for Special Needs Plans (SNPs)

Special Needs Plans are Medicare Advantage Plans designed to serve individuals with certain healthcare needs. Eligibility for a Special Needs Plan is determined by having a severe chronic condition, living in an institution, or being eligible for both Medicare and Medicaid (dual eligible). Special Needs Plans typically offer benefits, coverage, and healthcare provider access related to the condition for which the plan is designed.

Chronic conditions that may make you eligible for a Special Needs Plan include:

  • Autoimmune disorders
  • Cancer
  • Chronic heart failure
  • Dementia
  • Diabetes mellitus
  • End-stage liver disease
  • HIV/AIDS
  • Chronic lung disorders
  • Neurologic disorders
  • Stroke
Financial assistance

If you have a disability or chronic health condition, you may be eligible for financial assistance with Medicare and healthcare costs through programs such as:

  • Medicaid
  • Extra Help
  • Medicare Savings Programs
  • Social Security Income

Your state may offer additional financial assistance programs.

Get Help with Medicare Enrollment

If you have questions about Medicare plans you may be eligible for or want to enroll in a plan, our Medicare Advocates are standing by to help you. For a no-cost, personal consultation, call 1-800-991-4407 / TTY 711, 10 a.m. to 9 p.m. Eastern Time, Monday through Friday.

You can also find, compare, and enroll in Medicare Advantage Plans on your own through the Medicare Online Enrollment Portal. Search plans in your area, easily compare benefits side by side, and enroll in the plan that’s right for you.

Resources

Understanding Medicare and Medicaid

Benefits of a Medicare Advantage Plan

DIY Medicare Online Enrollment