If you’re under 65 years old and receive disability benefits, you’ll be automatically enrolled in Medicare after a waiting period of 24 months. The Medicare waiting period is waived if you have amyotrophic lateral sclerosis (ALS) or end stage renal disease (ESRD). There is no Medicare waiting period if you’re over 65 years old.

People under 65 who receive disability benefits through Social Security or the Railroad Retirement Board are eligible for Medicare. In most cases, you’ll be automatically enrolled in Medicare after a 2-year waiting period.

Your Medicare coverage will begin the first day of the 25th month that you receive benefits. You can apply for other types of coverage during the waiting period.

However, if you have either ALS or ESRD, you can receive Medicare coverage immediately, without the 2-year waiting period.

The 2-year Medicare waiting period only applies to individuals under 65 years of age who receive disability benefits — it doesn’t apply if you’re 65 or above. Americans are eligible to enroll in Medicare up to 3 months before their 65th birthday.

This means if you apply for Social Security Disability Insurance (SSDI) and are approved when you’re 64, your Medicare benefits will begin at 65, just like they would have if you didn’t receive SSDI. However, if you apply for SSDI at any other time, you’ll need to wait the full 2 years to receive Medicare.

SSDI has a separate waiting period of 5 months between when your application receives approval and when your benefits start. This is different from the Medicare waiting period. However, as with Medicare, the 5-month SSDI waiting period is waived if you have ALS.

Most SSDI recipients need to wait 24 months before Medicare coverage begins. However, there are exceptions. For people with certain severe health conditions, the waiting period is waived, and coverage begins sooner. You won’t need to wait the full 2 years if you have ALS or ESRD.

People with ALS

ALS, or Lou Gehrig’s disease, is a chronic condition that leads to loss of muscle control. It’s a degenerative condition, which means it will get worse over time. There’s currently no cure for ALS, but medication and supportive care can improve quality of life.

People with ALS need medical care to help them live comfortably. Many people with ALS need the care of home health nurses or nursing facilities. Since this disease can progress rapidly and requires a high level of medical care, the Medicare waiting period is waived.

If you have ALS, you’ll be enrolled in Medicare coverage as soon as you start receiving SSDI benefits.

People with ESRD

ESRD is sometimes referred to as kidney failure. It occurs when your kidneys no longer function well enough to meet your body’s needs.

ESRD is the last stage of chronic kidney disease. You’ll likely need dialysis treatments when you have ESRD, and you may be a candidate for a kidney transplant.

You don’t need to wait the full 2 years to receive Medicare coverage if you have ESRD. Your Medicare coverage will begin on the first day of the fourth month of your dialysis treatment. You can get coverage as soon as your first month of treatment if you complete a Medicare-approved training program to do your own at-home dialysis treatment.

In some cases, this can mean your coverage will actually start before you apply. For example, if you’re receiving dialysis at a medical center and apply for Medicare during your seventh month of treatment, Medicare will retroactively cover you, dating back to your fourth month.

You have a few options for coverage during the 2-year Medicare waiting period. These include:

  • Medicaid coverage: You might automatically qualify for Medicaid if you have a limited income, depending on your state’s policies.
  • Coverage from the Health Insurance Marketplace: You can shop for coverage using the United States Health Insurance Marketplace. The Marketplace application will consider you for Medicaid and for tax credits that could reduce your costs.
  • COBRA coverage: You can purchase the COBRA plan offered by your previous employer. However, you’ll pay the entire premium amount, including the part your employer paid.

Medicare coverage is available to people under age 65 years who receive Social Security disability benefits. Most people are automatically enrolled after a 2-year waiting period.

Medicare waives this waiting period if you have ALS or ESRD. Individuals who need health insurance coverage during the waiting period can take advantage of programs such as Medicaid, COBRA, or the Health Insurance Marketplace.