Can I get Medicare under 65 if I have a disability?

Yes — you can get Medicare under 65 if you have a qualifying disability. Three paths exist:

Path 1 — Social Security Disability Insurance (SSDI) recipients

If you've received SSDI cash benefits for 24 months, you're automatically enrolled in Medicare Parts A and B starting the 25th month.

• The 24-month waiting period is calculated from the month of your first SSDI cash payment (which itself comes after a 5-month waiting period from disability onset)
• Total time from disability onset to Medicare eligibility: typically 29 months
• Enrollment is automatic — Medicare cards arrive in the mail about 3 months before the 25th month
• No premium for Part A (you've earned credits through prior work)
• Standard Part B premium ($202.90/month in 2026, with possible IRMAA for higher-income recipients)

Path 2 — End-Stage Renal Disease (ESRD)

If you have permanent kidney failure requiring regular dialysis or a kidney transplant, you may qualify for Medicare regardless of age.

• Eligibility starts the 4th month of dialysis treatment (the 3-month waiting period can be waived if you complete a home dialysis training program within the first 3 months)
• For kidney transplant: eligibility starts the month you're admitted to a Medicare-approved hospital for the transplant
• Coverage runs for the duration of treatment + 36 months after a successful transplant
• Standard Part A and Part B available

Path 3 — Amyotrophic Lateral Sclerosis (ALS, Lou Gehrig's disease)

ALS-diagnosed individuals receive Medicare automatically upon receiving their first SSDI cash payment — no 24-month waiting period.

• Triggered by SSDI approval, which itself can be expedited under SSA's Compassionate Allowances list
• Coverage starts the same month as SSDI cash benefits begin

What you get with under-65 Medicare:

Same Parts A, B, and access to C and D as anyone else. You can:
- Stay on Original Medicare and add Medigap (though Medigap rules for under-65 vary by state — see below)
- Enroll in Medicare Advantage including SNPs
- Add Part D drug coverage
- Receive Extra Help and Medicare Savings Programs if income-qualified

The Medigap challenge for under-65 Medicare beneficiaries:

Federal law does NOT require Medigap carriers to sell to under-65 disabled Medicare beneficiaries. Whether you can buy Medigap and at what rate depends on your state:

States that REQUIRE carriers to offer at least one Medigap policy to under-65:
CA, CO, CT, DE, FL, GA, HI, IL, KS, KY, LA, ME, MD, MA, MI, MN, MS, MO, MT, NH, NJ, NY, NC, OK, OR, PA, RI, SD, TN, TX, VT, WI

States with limited/no requirement (only on a voluntary basis or specific conditions):
AL, AK, AZ, AR, ID, IN, IA, NE, NV, NM, ND, OH, SC, UT, VA, WA, WV, WY

Even in states that require offerings:
- Premiums for under-65 Medigap are typically 2–3x higher than for 65-year-olds
- Plan choices may be limited (often just Plan A or specific named plans)
- Specific underwriting rules apply

Strategy for under-65 Medicare beneficiaries:

1. Check your state's Medigap rules. If Medigap is unaffordable in your state, Medicare Advantage is usually the better path under 65.

1. Look at D-SNPs if you're also on Medicaid. Many under-65 disabled beneficiaries qualify for both Medicare and Medicaid. D-SNPs are often the best option — $0 premium, low/no copays, extra benefits.

1. At age 65, you get a NEW Medigap Open Enrollment — even if you've been on under-65 Medicare for years. This is a 6-month window where you can buy any Medigap policy with guaranteed issue and standard pricing. Don't miss this window.

1. Check Extra Help and MSP eligibility. Income limits are based on countable income; SSDI counts but many other resources don't.

1. Coordinate with employer coverage if you continued working. Some disabled beneficiaries continue working and have employer plans. Coordination of benefits rules are complex — get help.

Common mistakes:

• Thinking you'll be enrolled automatically in everything. You're enrolled in Part A and Part B automatically; Part D and MA require active enrollment.
• Not knowing about the 6-month Medigap Open Enrollment that opens at age 65.
• Picking an MA plan without verifying that your specific specialists (neurologists for MS, cardiologists, etc.) are in-network.
• Missing Extra Help and MSP applications — high under-65 disability beneficiary rates of unclaimed assistance.

What to do next: Call (866) 534-1886. We work with under-65 Medicare beneficiaries on plan selection, MA-vs-Medigap analysis based on your state's rules, Extra Help/MSP screening, and the critical age-65 Medigap re-enrollment window. Free.