Medicare Under 65

Medicare is geared toward seniors age 65 and up. But, it is also available to certain qualifying individuals under age 65.

Medicare for Those with ESRD

End-Stage Renal Disease (ESRD) occurs when chronic kidney disease — the gradual loss of kidney function — reaches an advanced state. With ESRD, your kidneys no longer work to meet your body’s needs.

If this applies to you, you can qualify for Medicare no matter your age. You must meet these specific requirements:

  • Your kidneys no longer work
  • You need regular dialysis or have had a kidney transplant
  • One of these must apply to you:
    • You’ve worked the required amount of time (10 years under Social Security, the Railroad Retirement Board (RRB), or as a government employee.
    • You’re already getting or are eligible for Social Security or Railroad Retirement benefits.
    • You’re the spouse or dependent child of a person who meets either of these requirements.

Medicare for Those with a Disability

If you are under age 65 and are unable to work due to a disability, you may qualify for Medicare. You must receive Social Security Disability Insurance (SSDI) for at least 24 months first to qualify. These months do not have to be consecutive. Once this happens, you can enroll in Medicare at any point.

Typically, a Medicare beneficiary with under 65 coverage would receive Original Medicare (Parts A and B). You may, however, be able to join a Medicare Advantage Special Needs Plan (SNP).

There are two types of SNPs — Chronic SNPs and Dual-Eligible SNPs. D-SNPs help those enrolled in both Medicare and Medicaid. So, if you are out on disability and have a lower income, you can receive additional financial assistance.

If you have a qualifying chronic disease or condition, you can receive a C-SNP to meet your exact medical needs.

Keeping Your Under 65 Coverage

As long as you’re considered medically disabled, you can continue to receive Medicare coverage even if you return to work. If you do, you won’t pay your Part A premium for eight and a half years.

Once this time has passed, you can purchase and pay for Part A. And, if you can’t afford this or your Part B costs, you may be eligible for state help.

Learn More with the Right Help

Our insurance experts work every day to answer questions and help people get the coverage they need. To learn more, call Magellan Healthcare.