The Social Security Disability Insurance Program, or SSDI, sets the disability requirements. You must first be SSDI-eligible in order to qualify for Medicare based on disability. Additionally, there is a list of impairments and requirements that you must meet to qualify for Medicare if you are under 65.
You typically need a disability that prevents you from working for at least a year to qualify for Medicare if you are under 65. A few examples are certain tumors, respiratory conditions, and musculoskeletal issues.
Everything you need to know about disabilities that qualify for Medicare before age 65 will be covered in this article.
Qualifying Illnesses For Social Security Disability Benefits
There isn’t a comprehensive list of ailments that qualify or don’t qualify for SSDI. The Social Security Administration does maintain a list of impairments for people in 14 categories that, if they are severe enough, may be eligible for SSDI.
PTSD, limb amputations, speech loss, chronic heart failure, and chronic liver disease are some of the specific disabilities on the list. One means of being eligible for SSDI is to meet specific clinical and functional requirements on the list.
You may still qualify even if you don’t have one of the above conditions. Additionally, there is a procedure to establish whether additional diseases are serious enough to qualify under the Social Security Administration.
Determining Whether Your Condition Qualifies
If your condition satisfies the criteria for SSDI eligibility, there are five steps you must go through. If approved for SSDI, you may later qualify for Medicare due to a disability.
The five inquiries the Social Security Administration uses to assess applicants for SSDI level of disability are listed below:
1. Are You Working?
There is an income cap to be eligible for SSDI if employed. In general, you won’t be able to earn more than $1,470 a month in 2023. If you are blind, the amount is $2,460 per month. The income cap may change annually, so be sure to check the SSA website to ensure you are not earning more.
2. Is Your Illness Serious?
Your illness must have a major effect on your ability to do basic work tasks for at least 12 months, owing to changes in your strength, mobility, or memory.
3. Is Your Illness Listed Among Disabilities Conditions?
The Social Security Administration maintains lists of medical disorders for adults and children categorized by the bodily system and those the agency believes may be severe enough to keep you from working. If the first two requirements are met and your illness is on the list, you have a qualifying impairment.
You’re not automatically ineligible if your condition is not listed. If your disease is as serious as those listed, the Social Security Administration must make that determination. You will proceed with the process if it does happen.
4. Can You Carry Out the Previous Work?
If your condition is not listed, the Social Security Administration considers whether your condition keeps you from doing any of your previous work. If so, you will proceed with the process.
5. Do You Have Any Other Kind of Employment?
The Social Security Administration considers various types of work you might still be able to undertake if your condition precludes you from doing labor you have previously done. There are more considerations besides your health. The Social Security Administration considers a person’s age, education, employment history, and abilities. If you cannot perform any other type of employment, you have a qualifying disability.
Medicare Work Requirements For Disabled
You must have a qualifying disability to be eligible for SSDI benefits, which might then qualify you for Medicare based on disability. However, merely possessing a qualifying impairment is insufficient; your job history must also meet SSDI guidelines.
The Social Security Administration calculates work history using the same Social Security work credits required for Social Security retirement payments.
Most applicants for SSDI must have 40 work credits, or ten years of labor, to be eligible. The federal government uses work credits as a unit of measurement for time spent working; one credit is equal to one-fourth of a year’s worth of work, subject to specified income minimums. Twenty credits worth of the qualifying work, or five years, must have been completed during the previous ten years.
A maximum of four credits may be earned annually. You will earn one credit for every $1,640 in wages or self-employment income in 2023. To complete all four credits in 2023, you would need to earn $6,560.
You may need a certain number of work credits, depending on your age. With fewer than 40 work credits, you can still be eligible for SSDI if you’re under 60.
When Does an Individual Start Getting Benefits?
24 Months After Qualifying for the Majority of Applicants
There is often a 24-month waiting period after you become eligible for SSDI compensation before you qualify for Medicare based on disability.
For those who are receiving SSDI payments and have specific conditions, there are exceptions.
For Those Who Have Specific Conditions: Earlier
Amyotrophic lateral sclerosis (ALS) is also referred to as Lou Gehrig’s disease.
The first month you get SSDI payments if you have ALS makes you eligible for Medicare.
End-Stage Renal Disease (ESRD)
If you have ESRD, you can receive Medicare benefits on the first day of the fourth month after starting dialysis. If you receive training for home dialysis, it might happen sooner.
Kidney Transplant Due To ESRD
If you have ESRD and need a kidney transplant, you will qualify for Medicare the same month you are hospitalized at a hospital that has received Medicare certification. Your coverage is only valid for two months before the transplant, so you may lose your eligibility if it is postponed or rescheduled.
How To Enroll in Medicare
When the necessary amount of time has passed, individuals eligible for Social Security disability benefits should receive a Medicare card in the mail. Contact your neighborhood Social Security office if this doesn’t happen or if you have any other inquiries.
Final Thought
SSDI standards must be satisfied before a person under 65 who wants to be eligible for Medicare based on disability can do so. The SSDI program offers a list of disabilities in several categories that may be eligible for Medicare if they are severe enough.
However, the absence of a condition on the list does not automatically rule out someone‘s eligibility. The Social Security Administration assesses the severity of other conditions on an individual basis. The Social Security Administration uses a five-step method to establish eligibility, which includes evaluating employment.
There are unique exclusions for people with illnesses like ALS, end-stage renal failure, or those getting a kidney transplant. A Medicare card should be mailed to eligible people for Social Security disability benefits. Still, if there are any problems, it is advised to contact your local Social Security office.
