When you Apply for Social Security do you get Medicare?

After you apply for disability benefits with the social security administration, and assuming that you meet the non-medical requirements as well as the disability criteria for receiving benefits, you "may" receive medicare. Why do we say the word "may"? Because receiving medicare depends on whether or not you qualify for Social Security Disability benefits, or SSI disability benefits.

SSI is a program that provides disability (and retirement) benefits to individuals who are not insured for title II. SSI does not come with medicare coverage but, instead, comes with access to medicaid, a program that provides prescription medication and access to physician care.

(Note: title II--of the social security act--is the official designation for Social Security Disability benefits which are available to individuals who have earned sufficient work credits during the course of their work activity to be considered insured and, thus, eligible, to receive Social Security Disability.)

A person who qualifies for SSI disability only cannot receive medicare benefits. Conversely, a person who receives a Social Security Disability award will receive medicare. However, this will be subject to a 2 year waiting period.

What do we mean by 2 year waiting period? The waiting period for medicare coverage does not mean that a person has to wait for two years after they have been notified of an approval for Social Security Disability. Instead, the two year waiting period means that an individual will not receive medicare until they have become eligible to receive their first Social Security Disability check.

Fortunately, because of A) the fact that most disability claims take 1-3 years to finish and B) the fact that the onset date for a person's disability benefits can often be far in the past because their medical evidence supports that onset date, it is often the case that a person who is granted Social Security Disability benefits will have only a small amount of time to wait for their medicare coverage to kick in. In many cases, there is no wait at all.

About the Author: Tim Moore is a former Social Security Disability Examiner in North Carolina, has been interviewed by the NY Times and the LA Times on the disability system, and is an Accredited Disability Representative (ADR) in North Carolina. For assistance on a disability application or Appeal in NC, click here.

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