For most people on disability, there's no separate Medicare application. Medicare comes with Social Security Disability Insurance (SSDI) after a waiting period. What you do have to apply for is SSDI itself, plus the choices that aren't automatic: drug coverage, any Medicare Advantage or Supplement plan, and help with costs. Kidney failure is the one case where you must sign up for Medicare yourself. This page walks through each step in order. For the full timeline, see our guide to Medicare under 65 on disability.
Do I need to apply for Medicare if I'm on disability?
Usually not. If your Medicare is based on SSDI or ALS, Social Security enrolls you in Part A and Part B automatically. Your card arrives about 3 months before coverage starts.
Medicare starts in your 25th month of disability benefits, after SSDI's 5-month waiting period. With ALS, it starts as soon as your disability benefits start. End-Stage Renal Disease (ESRD) is different: you sign up through Social Security yourself. See do you automatically get Medicare on disability for the details.
Step by step: from SSDI application to Medicare coverage
- Apply for SSDI. Apply online at SSA.gov, or call Social Security at 1-800-772-1213 to set up an appointment by phone or in person. SSDI requires a disability expected to last at least a year and enough work history.
- Wait for the decision. Social Security sends medical review to your state's Disability Determination Service. You'll get a letter approving or denying your claim. Keep your award letter: it shows the month your entitlement started, which sets your Medicare date.
- Cover the gap. Medicare usually starts about 29 to 30 months after your disability began. Plan coverage for the wait: COBRA, a Marketplace plan or Medicaid. See health insurance until Medicare starts.
- Watch for your Medicare card. It should arrive about 3 months before Medicare starts. If it hasn't come by the end of the first month of your 7-month window, contact Social Security.
- Decide about Part B. If you keep the card, you keep Part B and pay its premium. Whether you can delay Part B without a late-enrollment penalty depends on your specific situation, including whether you have group health coverage based on your own or your spouse's current employment. Employer size can also affect how Medicare coordinates with that coverage, so we check the details before you decide.
- Choose drug coverage and any plan. During your 7-month window around your 25th month, join a drug plan or a Medicare Advantage plan. You can join through Medicare.gov, the plan, or 1-800-MEDICARE.
- Apply for help with costs if you need it. Medicare Savings Programs and Medicaid are run by your state, and Extra Help runs through Social Security.
How do I sign up for Medicare with kidney failure (ESRD)?
You apply through Social Security, at a local office or by calling 1-800-772-1213. ESRD Medicare isn't automatic. For in-center dialysis, coverage generally begins with the fourth month of dialysis, and sooner in some home-dialysis and transplant situations. If you're approved because of ESRD, you can sign up for Part B without a late-enrollment penalty. If you also have a job-based group health plan, it pays first for a 30-month coordination period.
How do I apply for a Medicare plan or a Supplement?
- Drug plans and Medicare Advantage: enroll through Medicare.gov, the plan itself, or 1-800-MEDICARE during an enrollment window. If you join before Medicare starts, the plan starts the same day your Medicare does. See Medicare Advantage under 65 on disability.
- Medicare Supplement (Medigap): you apply to the insurance company. Under 65, timing and access depend on your state. In North Carolina, apply within 6 months of first enrolling in Part B. In South Carolina, the guaranteed option is the state pool (SCHIP). In Tennessee, apply within 6 months of Part B or after certain coverage losses.
How do I apply for help paying Medicare costs?
| Program | Where to apply |
|---|---|
| Medicare Savings Programs and Medicaid, North Carolina | NC Medicaid: online, in person, by phone or by mail through your county Department of Social Services. Contact center 1-888-245-0179. |
| Medicare Savings Programs and Medicaid, South Carolina | Healthy Connections: apply online through SCDHHS, or call (888) 549-0820. |
| Medicare Savings Programs and Medicaid, Tennessee | TennCare Connect: online, by phone at 855-259-0701, or on paper. |
| Extra Help with drug costs | Social Security, unless you get it automatically through Medicaid, a Medicare Savings Program or SSI. More from Medicare.gov. |
See help paying for Medicare and having both Medicare and Medicaid.
What if I turned down Part B and want it back?
You can generally sign up during the General Enrollment Period, January 1 to March 31, unless you qualify for a Special Enrollment Period. Coverage starts the month after you sign up, and a late-enrollment penalty may apply. A penalty from your disability years stops at 65.
Mistakes we see people make
- Waiting for a Medicare application that never comes. With SSDI, Medicare is automatic. Watch the mail instead.
- Assuming ESRD works the same way. With kidney failure, nothing happens until you sign up.
- Losing the award letter. Its dates drive every Medicare deadline.
- Skipping drug coverage because Medicare "is automatic." Drug coverage is a separate choice.
- Not applying for help with costs because they assume they earn too much.
How The Jordan Insurance Agency helps
A licensed agent from The Jordan Insurance Agency will map your dates from your award letter, tell you which steps are automatic and which aren't, and help you choose drug coverage and any plan, checking your doctors and prescriptions first. We work by phone, by video, or in person at our office at 3540 Toringdon Way, Suite 200, Charlotte, NC 28277, Monday through Friday, 9 to 5 Eastern, at no cost to you. Call (704) 926-7565 or use the button below to schedule a Medicare review. You can also read more on our Medicare page or browse our Medicare questions answered.
Frequently asked questions
Is there a Medicare application for people on SSDI?
No. If your Medicare is based on SSDI or ALS, Social Security enrolls you in Part A and Part B automatically, and your card arrives about 3 months before coverage starts.
Where do I apply for SSDI?
Online at SSA.gov, or by calling Social Security at 1-800-772-1213 to set up an appointment by phone or in person.
How do I get Medicare if I have kidney failure?
You apply through Social Security, at a local office or by calling 1-800-772-1213. For in-center dialysis, coverage generally begins with the fourth month of dialysis.
Do I have to sign up for a drug plan separately?
Yes. Part A and Part B are set up for you, but drug coverage is a separate choice. You can join a drug plan or a Medicare Advantage plan with drug coverage during your 7-month window around your 25th month of benefits.
Where do I apply for a Medicare Savings Program?
Through your state Medicaid agency: NC Medicaid through your county Department of Social Services, Healthy Connections in South Carolina, or TennCare Connect in Tennessee.
Reviewed and approved by Billy Jordan, Jr., licensed agent and President of The Jordan Insurance Agency.
Last reviewed: October 2026
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