Do I have to have Medicare if I am on disability?

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Identifying Your Eligibility For Medicare

Typically a healthcare insurance provision for those aged 65 and over, Medicare exists as a potential healthcare insurance option for a handful of those under the age of 65 – depending on whether they are living with a disability or meet specific criteria with regards to a disease. 

In order to become eligible for Medicare cover through a disability or disease such as end-stage renal disease, you must meet the following criteria:

  • You must be receiving Social Security benefits for at least 24 months before you become eligible for Medicare, OR
  • You must meet specific time limits outside of these 24 months if you are living with end-stage renal disease or Lou Gehrig’s disease. This means applying for Medicare as soon as you receive your disability benefits.

Is Medicare Mandatory If I Meet the Criteria For Eligibility?

One of the big things to note about Medicare is that in some cases, including those living with a disability, the 24 months of Social Security disability support will render you eligible for Medicare and so you will become automatically enrolled. If it gets to this stage, opting out can be pretty difficult with a long and arduous process, which makes little sense – especially if you are going to be facing some big medical and healthcare treatment bills in the near future. 

If you decline Medicare insurance and coverage when you first become eligible, enrolling at a later date is often possible but comes with fines and penalties – with your monthly premiums likely reflecting the delay in enrollment with fees, which can push your monthly payments much higher. If you decide to decline Medicare coverage all together, you may be required to withdraw from all of your other benefits as well – leaving you without Social Security disability benefits as well as without healthcare insurance.

What Is The Best Course of Action For Someone Living With a Disability?

The easiest solution, especially if you aren’t sure whether you want full Medicare coverage or not, is to enroll in Part A premium-free and simply choose not to use it if you wish. By enrolling, you remain eligible for your other benefits and can decide to add additional Medicare coverage at a later date – though again we advise that this will come with higher fees and larger premiums. 

In short, Medicare is not mandatory in any case, but the process of declining and removing yourself from the service is not a simple one and in most cases, beneficiaries find that the cover offered is worth the enrollment. 

For more information on whether you are eligible to receive Medicare insurance, and how to best use and apply it for your own gain, get in touch with our team at Bobby Brock Insurance.

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Justin Brock

President & CEO of Bobby Brock Insurance