Medicare Under 65

The thought surrounding Medicare is that it’s only for those aged 65 or older. However, that’s not always the case. In fact, Medicare Under 65 exists for those who have qualifying medical conditions.

But how do you know what those conditions are or if you can start Medicare before age 65? Keep reading for all the answers.

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Can You Be On Medicare Before Age 65?

Many beneficiaries start their Medicare under the age of 65. Usually, you must wait until you turn 65 to begin your Medicare, and you’ll automatically qualify for Medicare with certain conditions.

Those with conditions that don’t allow you to start Medicare immediately can still get Medicare under 65. You’ll have to wait until 24 months after you’re on disability.

Conditions that’ll automatically qualify you for disability are Amyotrophic Lateral Sclerosis (ALS) and End-Stage Renal Disease (ESRD).

Amyotrophic Lateral Sclerosis

Amyotrophic Lateral Sclerosis is a neurodegenerative disease affecting the brain and spinal cord nerve cells. This disease will cause you to lose control of your muscles, and ALS is also referred to as Lou Gehrig’s disease.

If diagnosed with Amyotrophic Lateral Sclerosis, your Medicare will start automatically the day you start disability benefits.

End-Stage Renal Disease

End-Stage Renal Disease is when your kidneys have failed and can’t filter blood as they should. When this happens, toxins and waste build up in your body.

Suppose you have kidney failure and require dialysis or a kidney transplant. In that case, you may be eligible for Social Security disability insurance. You can get payments without waiting by applying at your local Social Security office.

What Other Conditions Qualify For Medicare Before 65?

Many health conditions and disabilities qualify you for Medicare before you reach age 65. For most conditions that apply, you must be on disability for 24 months before Medicare starts.

Here are some of the most common:

If you qualify for Medicare, enroll immediately. You may want to contact Medicare and sign up for coverage if you have a disability or a health issue that qualifies you for the program. You could also get advice on your Medicare options from an insurance representative.

Medicare Coverage Options for Beneficiaries Under 65

If you have both a qualifying disability and are under 65, Medicare will start automatically 24 months after you go on disability. In most states, you have access to the same options that beneficiaries 65 or older have available.

Medicare Advantage

Medicare Advantage is one way to get Medicare coverage. It’s similar to Original Medicare but handles your health care instead of Original Medicare. It includes all the same advantages as Original Medicare and extra items like gym memberships, vision care, dental care, and hearing aid coverage.

You must enroll in Medicare Advantage plans during valid enrollment periods such as the Annual Enrollment Period and the Medicare Advantage Open Enrollment period. The coverage you can get from Medicare Advantage will be precisely the same as a beneficiary that is 65 or older.

Original Medicare

You can always stay on Original Medicare only and pick up a prescription drug plan on Medicare Under 65. This allows freedom from networks and referrals, but you have no cap on the maximum you can pay. Your risk can be very high because you lack a cap on your spending.

Prescription drug plans will work exactly the same for you as for beneficiaries over 65.

Medicare Supplements

Suppose you want to retain the network freedom. In that case, you can choose to add a Medigap to Original Medicare to limit what your out-of-pocket cost will be.

Some states allow you to purchase a Medicare Supplement plan if you are enrolled in Medicare Under 65. The prices may be significantly higher for the monthly premium in many states compared to the same Medicare Supplement for a beneficiary that is 65 or older.

FAQs

I’m under 65 and have a disability. Does Medicare cover me?

Medicare starts automatically if you’ve been diagnosed with a qualifying health condition or been on disability for at least 24 months.

Medicare will cover you for the same items as it would for a beneficiary that is 65 or older. Speak to a licensed insurance broker specializing in Medicare to learn more about your specific needs.

Even though I’m not yet old enough to receive Medicare benefits, can I still use Medicare?

Yes, if you have a qualifying health condition or have received disability benefits for 24 months.

How do I sign up for Medicare if I’m under 65?

Medicare will start automatically if you have Lou Gehrig’s Disease or have been on disability benefits for 24 months. If you’re diagnosed with End-Stage Renal Disease and need dialysis or a transplant, you can apply and receive Medicare.

Can I enroll in Medicare Advantage if I’m on Medicare under 65?

Yes, Medicare Advantage is available to Medicare beneficiaries regardless of age. The Medicare Advantage plan will provide the same coverage as it would for a beneficiary that’s 65 or older.

Can I add a Medicare supplement to Original Medicare if I’m on Medicare under 65?

Some states allow Medicare beneficiaries enrolled in Medicare Under 65 to purchase a Medicare Supplement plan. The prices may be significantly higher for the monthly premium.

Getting Additional Coverage For Medicare Before 65

Getting Medicare before 65 can be a lifesaver if you have a qualifying ailment. Unfortunately, Medicare alone won’t cover everything 100%. That’s why getting a Medicare Supplemental plan can be smart to get the most comprehensive coverage you can afford.

Our licensed insurance agents are standing by to share their wealth of knowledge about Medicare and all the Medigap plans available. Their time is of no charge to you, so any questions you have will receive answers.

So when you’re ready to talk to our agents, call us. Or complete our online rate form to be connected with the best rates in your area.

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Written By:
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Lindsay Malzone, Lindsay Malzone is the Medicare editor for Medigap.com. She's been contributing to many well-known publications since 2017. Her passion is educating Medicare beneficiaries on all their supplemental Medicare options so they can make an informed decision on their healthcare coverage.
Reviewed By:
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Rodolfo Marrero, Rodolfo Marrero is one of the co-founders at Medigap.com. He has been helping consumers find the right coverage since the site was founded in 2013. Rodolfo is a licensed insurance agent that works hand-in-hand with the team to ensure the accuracy of the content.