Medicare for Disabled People Under 65: How To Get Coverage

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Medicare covers about 7 million people under age 65 who have certain disabilities and medical conditions. This includes people who have heart disease, Parkinson's disease and other long-term medical conditions.

What disabilities qualify for Medicare under 65?

Examples of medical conditions that make you eligible for Medicare before age 65

Many other conditions can qualify you for Medicare before age 65. To see if you're eligible, check the Social Security Administration list of qualifying medical conditions. If you're under age 18, there is a different list of qualifying medical conditions.

What is the waiting time for Medicare benefits to begin?

With most diseases and conditions, Medicare coverage begins 24 months after disability benefits (SSDI) payments start.

Exceptions to the two-year waiting period

The 24-month waiting period does not apply to people with kidney failure and ALS.

How much does Medicare cost for disabled people under 65?

People who qualify for Medicare because of a disability pay the same amount as seniors for Original Medicare (Parts A and B). All Medicare enrollees have the same rates for Medicare Advantage and Part D plans offered in their location.

Medicare Part A (hospital insurance)

Medicare Part B (pays for doctor visits)

Medicare Part C (Medicare Advantage)

Medicare Part D (prescription drug plan)

Medicare Supplement (Medigap)

Is Medicare Advantage a good choice for disabled Medicare beneficiaries under 65?

It's an affordable way to get coverage, and there's a wide range of plan options, so you can choose the coverage you need. However, the plans do have major drawbacks, including restricting you to a network of doctors.

Medicare Advantage plans, also known as Medicare Part C plans, are "all-in-one" alternatives to Original Medicare. They include Medicare Part A, Part B and usually Part D prescription drug coverage. With these plans, you don't need to buy separate Part D and Medigap plans, as you would with Original Medicare.

Unlike Original Medicare, Medicare Advantage plans limit the amount you'll pay for medical care in a single year. You won't pay more than $9,250 per year for in-network care, although many plans cap your annual payments at a lower amount. In contrast, you could face unlimited health care costs with Original Medicare and no Medigap coverage.

Special Needs Plans

Unlike Original Medicare, Medicare Advantage offers Special Needs Plans (SNPs) for people with specific disabilities and medical conditions. These plans have extra, tailored coverage that goes beyond what a normal Medicare Advantage plan might offer.

The two most common SNPs are Chronic Condition Special Needs Plans (C-SNPs) and Dual-Eligible Special Needs Plans (D-SNPs).

Drawbacks of Medicare Advantage

Medicare Supplement for people who have disabilities

With some Medicare Supplement plans, also called Medigap plans, you'll end up paying very little for your medical care. If you have ongoing health care needs, like many people with disabilities and chronic conditions do, Medigap can help you keep your medical costs low. The downside is that you'll usually pay high costs for a plan.

Additionally, you may not be able to get Medigap coverage at all, depending on where you live. Not all states require companies to sell plans to people under age 65.

For example, Medicare Supplement companies in California are required to sell at least one Medigap plan to people under age 65, but they aren't required to sell plans to people with kidney failure.

Other states don't have specific laws about offering plans to people with kidney failure or ALS, which means the insurance companies can decide on their own if they want to sell plans to people with these conditions.

Keeping Medicare benefits after going back to work

If you are under age 65, you can keep your Medicare benefits when going back to work, as long as your medical condition or disability still meets Medicare's coverage rules.

Even if you lose your Social Security disability benefits, you can still get Medicare benefits for eight and a half years.

However, if your employer offers health insurance, you may have to take that coverage. You can still keep Medicare, but your Medicare coverage may pay for care that your work insurance doesn't cover. This means Medicare would be considered secondary insurance.

Frequently asked questions

Methodology and sources

Original Medicare rates, coinsurance and deductibles for 2026 are from Medicare.gov and the Centers for Medicare & Medicaid Services (CMS).

Medicare Advantage rates

The cost of Medicare Advantage in 2026 comes from public use files released by the Centers for Medicare & Medicaid Services (CMS). Rates are for plans that include prescription drug coverage. Special needs plans, sanctioned plans, PACE plans, prepayment plans (HCPPs), Medicare medical savings account (MSA) plans and employer-sponsored plans were excluded from our analysis.

Medicare Part D rates

Medicare Part D rates also come from data released by CMS. Rates are for stand-alone prescription drug plans and do not include employer-sponsored and sanctioned plans. Averages include rates for all 50 states and Washington, D.C. but do not include U.S. territories.

Medicare Supplement rates

Medigap rates for 2026 come from actuarial data for private insurance companies. Rates are for a 65-year-old woman who doesn't smoke and who signed up for a plan when she was first eligible and medical status isn't factored into rates. Rates do not include plans in Massachusetts, Minnesota and Wisconsin, which have their own Medigap systems.

Other sources include the Department of Health and Human Services and KFF.