Amyotrophic Lateral Sclerosis (ALS), also known as Lou Gehrig’s disease, qualifies individuals for expedited Medicare coverage due to the severe and progressive nature of the condition. This article outlines the process for applying, waiting periods, and whether separate Medicare enrollment is necessary.
Eligibility and Application Process
Individuals diagnosed with ALS become eligible for Medicare based on disability, regardless of age.
The first step is to apply for Social Security Disability Insurance (SSDI) through the Social Security Administration (SSA). This can be done online, by phone, or at a local SSA office.
It is crucial to explicitly state ALS as the disabling condition on the SSDI application to ensure expedited processing under the Compassionate Allowances program.
Waiting Periods
The standard 24-month waiting period for Medicare after SSDI approval is waived for ALS patients.
There is a five-month waiting period from the date of disability onset before SSDI cash benefits begin.
Once the five-month SSDI waiting period is complete and benefits begin, Medicare coverage starts automatically in the same month as the first SSDI payment.
Medicare Enrollment: Automatic or Separate?
No separate Medicare application is required. Enrollment is automatic for ALS beneficiaries once SSDI benefits begin.
The beneficiary will receive their Medicare card in the mail, typically within a few months after SSDI approval.
Both Medicare Part A (hospital insurance) and Part B (medical insurance) become available; Part B can be declined if the beneficiary has other coverage, but automatic enrollment occurs unless declined.
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