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2 Year Waiting Period for Medicare

by | Oct 18, 2015 | Social Security Disability |

2 Year Waiting Period for Medicare

Under the regulations for Social Security disability, an individual must receive Social Security disability benefits for two years before they are eligible to receive Medicare. In 1972, Medicare was expanded to include individuals with disabilities under Social Security disability. The 24 month time period was enacted so as to keep Medicare costs down and with the belief that many individuals receiving Social Security disability benefits would still be under a private group health plan. However, it is now estimated that 1.8 million individuals receiving Social Security disability are currently in the waiting process for Medicare.

In a July 2003 Commonwealth Fund Report, 39 percent of individuals, whose disability has been found to be severe enough to qualify for Social Security Disability, go without health insurance coverage at some point during the waiting period for Medicare. 24 percent of those individuals have no health insurance during the entire 24 month waiting period. A March of 2008 Health Affairs article “Transitioning to Medicare Before Sixty-Five” found that for those Americans in the waiting period aged 55-64, 50 percent did not have insurance prior to the waiting period, 36 percent of individuals lost employer coverage while in the waiting period, and 4 percent lost the Medicaid coverage they had prior to being approved for Social Security disability.

Many argue that eliminating the 2 year waiting period would put a financial strain on the Medicare system. Studies have shown that eliminating the 2 year waiting period would cost the federal government $113 billion over a ten year period. However, eliminating the 2 year waiting period would reduce Medicaid spending by $32 billion over a 10 year period and would increase tax revenue by $3 billion due to lower health insurance costs for employment-based plans.

Because of the 2 year waiting period for Medicare, many individuals with severe disabilities forego medical treatments and medications due to the increasing costs of medical insurance. Sadly, many individual’s conditions worsen during this time leading to more intensive and costlier care. For more information on the Social Security disability benefits and the two year waiting period for Medicare, contact an experienced Social Security disability attorney at Gardberg & Kemmerly, P.C. today at 251-343-1111 for a free case evaluation. Gardberg & Kemmerly, P.C. represents Social Security disability claimants in Alabama, Mississippi, Florida, and Louisiana at all levels of the disability process from initial application to appeals to Federal Court.



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