Medicare on disability (SSDI): the 24-month wait and what to do meanwhile

How people under 65 get Medicare through Social Security Disability Insurance, the waiting period, the exceptions for ALS and ESRD, and coverage during the gap.

About one in seven people with Medicare is under 65. Most qualify through Social Security Disability Insurance (SSDI).

The timeline

SSDI cash benefits begin after a five-month waiting period from the date Social Security says your disability began. Medicare begins after you have received SSDI for 24 months. In practice, that is about 29 months after the disability started.

Typical path: 5-month SSDI wait, then 24 months of benefits before Medicare.

You are enrolled in Parts A and B automatically and your card arrives about three months before Medicare starts. You can decline Part B, but read about the Part B late penalty first.

Exceptions

ALS (Lou Gehrig's disease): Medicare starts the same month SSDI starts. No 24-month wait.
End-stage renal disease: separate rules; see Medicare for kidney failure.

Coverage during the wait

Marketplace coverage (HealthCare.gov or your state exchange), often with subsidies.
Medicaid, if income and assets qualify.
COBRA from a former employer.
A spouse's employer plan.

Medigap under 65

Federal law does not require insurers to sell Medigap to people under 65. Many states do. Washington and Florida both have rules; see Washington under-65 options and Florida's under-65 rule.

At 65

When you turn 65, you get a new Medigap open enrollment period, with full access to every plan at standard rates. Licensed agents such as Maru Insurance can quote plans then.

Questions people ask

How long is the wait for Medicare on SSDI?

24 months of SSDI benefits, after a five-month SSDI waiting period.

Is there a wait for ALS?

No. Medicare starts when SSDI starts.

Can I buy Medigap under 65?

Depends on your state; many states require insurers to offer at least one plan.

Do I get another Medigap window at 65?

Yes, a new six-month open enrollment at 65.

Independent educational site. Not affiliated with or endorsed by the U.S. government, the federal Medicare program, or any insurance company. Figures are 2026 amounts published by CMS unless noted; check Medicare.gov for your situation.