24 monthsSSDI benefits before Medicare begins
Month 1ALS: Medicare starts with SSDI
4th monthESRD: coverage usually starts
$202.90Part B premium in 2026
Three ways to qualify before 65
| Reason | When Medicare starts |
|---|---|
| Disability (SSDI) | After you have received SSDI payments for 24 months |
| ALS (Lou Gehrig's disease) | The first month your SSDI payments begin; no 24-month wait |
| End-stage renal disease (kidney failure needing dialysis or a transplant) | Usually the first day of the 4th month of dialysis; sooner if you take part in a home dialysis training program or have a transplant |
You do not need to apply separately in most cases. If you qualify through SSDI, Medicare Parts A and B enrollment is automatic when you reach month 25. For ESRD, apply through Social Security.
Costs are the same as for everyone else
Part B is $202.90 a month in 2026 with a $283 deductible. Part A is premium-free for most people with enough work credits. See all 2026 Medicare costs. If your income is limited, a Medicare Savings Program and Extra Help may lower your costs.
Medicare Advantage and Medigap
- Medicare Advantage is open to people with ESRD, and to others under 65 who have Medicare because of disability.
- Medigap: federal law does not require insurers to sell Medigap to people under 65, although many states do. Prices may be higher. You get a guaranteed 6-month window when you turn 65 and have Part B, so plan around it.
What happens at 65
You stay on Medicare, but you receive a new 6-month Medigap open enrollment window when you turn 65. If you were on SSDI, your benefit converts to a retirement benefit at full retirement age.
Approved for SSDI and wondering about the 24-month wait? Read the SSDI guide and the SSI vs SSDI comparison. If you were denied, see how to appeal.
The 24-month clock starts with your SSDI entitlement, which includes a 5-month waiting period before payments begin, so the wait from disability onset can be longer.