Question 1

Is there a waiting period for Medicare with ALS?

Accepted Answer

No. For ALS (Lou Gehrig's disease), Medicare begins as soon as SSDI benefits start — there is no 24-month waiting period. This is a specific exception to the standard disability Medicare rules. The trigger is when SSDI payments begin, not when the diagnosis occurs.

Question 2

What happens to my disability Medicare at 65?

Accepted Answer

It transitions to age-based Medicare automatically — no re-enrollment required. The employer coordination threshold changes from 100 employees to 20 employees at 65. You also gain new Medigap guaranteed-issue enrollment rights at 65 regardless of any pre-existing conditions.

Question 3

Can I work while on disability Medicare?

Accepted Answer

There are programs that allow limited work while keeping Medicare, including the Trial Work Period and Extended Period of Eligibility. Contact Social Security to understand how work activity affects your SSDI benefits and Medicare eligibility before returning to work.

Question 4

What should I do about Part D when disability Medicare starts?

Accepted Answer

Enroll in a Medicare Part D prescription drug plan within 63 days of your Part A effective date. If you have creditable drug coverage from an employer plan, you can delay Part D — but request the annual creditable coverage notice from your employer to document this protection. Missing the 63-day window without creditable coverage triggers a permanent Part D penalty.

Question 5

What happens if I skip Part B when first eligible through disability Medicare?

Accepted Answer

If you skip Part B and later need to enroll, you generally must wait for the General Enrollment Period (January through March). A late enrollment penalty may apply for the time you went without Part B. Consult Social Security before skipping Part B to understand the implications for your specific situation.

Question 6

Do I qualify for Medicaid or Extra Help on disability Medicare?

Accepted Answer

Many disability Medicare recipients qualify for Medicaid and Medicare Part D Extra Help based on income and assets. Medicaid can cover Medicare premiums, deductibles, and copayments. Extra Help (Low Income Subsidy) significantly reduces Part D drug costs. Contact your state Medicaid office or call 1-800-MEDICARE to check eligibility.

Question 7

How does the 100-employee rule work for disability Medicare?

Accepted Answer

During disability-based Medicare (before age 65), employer group health coverage from an employer with 100 or more employees is generally primary over Medicare for the first 30 months of Medicare eligibility. For employers under 100 employees, Medicare is primary from day one — you should enroll in Part B to avoid claim coordination gaps.

Medicare With Disability: SSDI, ALS, ESRD Timing

When This Applies

Frequently Asked Questions