Millions of Americans suffer from disabilities that make it difficult or even impossible to accomplish daily tasks. Fortunately, Medicare offers additional help and coverage for those who suffer from specific, long-term conditions. Today, we’re going to take a closer look at the relationship between disability and Medicare. Additionally, we will explain exactly how Medicare covers patients with disabilities. Read on to learn more about what you can expect to get from Medicare if you have a qualifying disability.

What Qualifies as a Disability Under Medicare?

There are hundreds of conditions that qualify as disabilities under Medicare. However, there are also some long-term health conditions that do not qualify as disabilities. Generally, Medicare and the Social Security Administration group qualifying disabilities into two categories: Adult Impairments and Childhood Impairments. First, let’s look at the adult impairments:

  • Musculoskeletal System
  • Special Senses and Speech
  • Respiratory Disorders
  • Cardiovascular System
  • Digestive System
  • Genitourinary Disorders
  • Hematological Disorders
  • Skin Disorders
  • Endocrine Disorders
  • Congenital Disorders That Affect Multiple Body Systems
  • Neurological Disorders
  • Mental Disorders
  • Cancer (Malignant Neoplastic Diseases)
  • Immune System Disorders

It’s important to note that these are mere “categories” of disabilities. Within each category are dozens of specific conditions. In any case, let’s move on to the childhood impairments:

  • Low Birth Weight and Failure to Thrive
  • Musculoskeletal System
  • Special Senses and Speech
  • Respiratory Disorders
  • Cardiovascular System
  • Digestive System
  • Genitourinary Disorders
  • Hematological Disorders
  • Skin Disorders
  • Endocrine Disorders
  • Congenital Disorders That Affect Multiple Body Systems
  • Neurological Disorders
  • Mental Disorders
  • Cancer (Malignant Neoplastic Diseases)
  • Immune System Disorders

You can learn more about specific disability coverage on the Socal Security Administration website.

Does Medicare Cover Patients Under 65 With Disabilities?

In short, yes. Medicare does cover patients under 65 with qualifying disabilities. In order to receive Medicare benefits with a disability before turning 65 years old, you must meet at least one of the following requirements:

  • You have been receiving Social Security benefits for at least 24 months,
  • You have End-Stage Renal Disease (ESRD), or
  • You have Amyotropic Lateral Sclerosis (ALS)

How Does Medicare Coverage Differ For Patients With Disabilities?

In addition to being able to enroll early, patients with disabilities also get some special coverage options from Medicare. Generally, your coverage will be very similar to someone without a disability. You will still need to pay your premiums, coinsurances, and deductibles. However, you may qualify for unique Medicare plans, including a Special Needs Plan (SNP). With a Special Needs Plan, you get medical coverage that is tailored to meet the needs of your specific condition, providing additional coverage for treatment, drug costs, and other associated expenses.

The Bottom Line

Having a disability can make it difficult to maintain work or even do the kinds of activities that you love. Disabilities can also lead to high medical costs. Fortunately, Medicare has you covered. Whether you have Original Medicare, Medicare Advantage, or even a Special Needs Plan, you can get help paying for your medical bills!

If you’d like to learn more about the relationship between disabilities and Medicare or your Medicare coverage options, feel free to fill out this form or give us a call anytime. Time for 65’s partnered licensed agents are focused on giving you the information you need, with zero pressure to enroll in a plan.