People under age 65 can qualify for Medicare in three main ways: by receiving Social Security Disability Insurance (SSDI) for 24 months, or by receiving a diagnosis of amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig’s disease, or end-stage renal disease (kidney failure). The path to coverage typically begins with applying for SSDI benefits through the Social Security Administration, which has a five-month waiting period before eligible applicants begin receiving cash payments.
Understanding SSDI and Medicare Timelines
Once approved for SSDI, individuals must wait an additional 24 months before becoming eligible for Medicare—meaning the total wait from disability onset to coverage can be effectively 29 months when the initial Social Security waiting period is included. However, those with ALS or end-stage renal disease have this waiting period completely waived, allowing Medicare Parts A and B coverage to begin the same month SSDI benefits start. People can access health insurance during the waiting period through their state’s Affordable Care Act marketplace or a spouse’s employer-sponsored plan.
Qualifying Conditions and Application Process
The Social Security Administration defines disability broadly as any condition that prevents someone from performing regular, continuous work activity on a full-time basis and is expected to last at least 12 months. Qualifying conditions range from Alzheimer’s disease, asthma, autism spectrum disorders, chronic heart disease, chronic obstructive pulmonary disease, severe depression, epilepsy, HIV/AIDS, and lupus to severe arthritis. About 15% of Medicare beneficiaries are people with disabilities younger than 65.
Support Resources for Enrollment
Once the 24-month waiting period is met, individuals are automatically enrolled in Medicare. The Centers for Medicare & Medicaid Services operates a 24/7 call center at 1-800-Medicare (1-800-633-4227) to help people determine eligibility and navigate enrollment. The State Health Insurance Assistance Program (SHIP), available in every state and territory, offers free one-on-one assistance from local counselors to help individuals understand their options and complete applications.
This article is an AI-assisted summary. All facts and figures are drawn from the original report: https://wtop.com/news/2026/06/medicare-eligibility-for-people-under-65-with-disabilities/