Partners Serving Individuals with Disabilities, Pre-Existing & Chronic Health Conditions
The Centers for Medicare & Medicaid Services (CMS) partners with national organizations to ensure that persons with disabilities, pre-existing and chronic health conditions receive access to quality health insurance and health care information.
Medicare is automatically available for certain individuals with disabilities under age 65 who have received Social Security Disability benefits for 24 months or have End Stage Renal Disease (ESRD) or Amyotrophic Lateral Sclerosis (ALS, also known as Lou Gehrig’s disease). Individuals with ESRD and ALS, do not have to serve a 24 month waiting period and will automatically receive Medicare Parts A and B the month their Social Security Disability benefits begin.
How Medicare Works With Other Insurance
If you are under 65 and have a disability, and have group health plan coverage based on your family member’s current employment and the employer has 100 or more employees, your group health plan insurance pays first. Click here for more information about Medicare benefits.
Help Paying Medicare Health Care Costs
You may be eligible to get help from your state to pay your Medicare premiums if you have limited income and resources and meet certain conditions. Below are the four kinds of Medicare savings programs (the names of these programs and how they work may vary by state):
- Qualified Medicare Beneficiary (QMB) Program
- Specified Low-Income Medicare Beneficiary (SLMB) Program
- Qualifying Individual (QI) Program
- Qualified Disabled and Working Individuals (QDWI) Program
Click here for more information about Medicare Savings Programs.
Medicaid is a joint federal and state government program that helps with medical costs for people with limited income and resources. Medicaid may also cover services not normally covered by Medicare (like long term supports and services and personal care services). The open enrollment period for Medicaid is year round and each state has different rules about eligibility and applying for Medicaid. To enroll, go to www.HealthCare.gov or visit your state Medicaid agency.
Dual Medicare/Medicaid Eligibility
Dual eligible beneficiaries are eligible for both Medicare and Medicaid and are generally enrolled in Medicare Part A and/or Part B and receiving full Medicaid benefits and/or assistance through a Medicare Savings Program (MSP). Medicare and Medicaid dual eligible benefits vary by state.
- For more information on dual eligibility, click here.
- To learn about programs that help people with limited income and resources work with Medicare, click here.
Children’s Health Insurance Program (CHIP)
The Children’s Health Insurance Program (CHIP) is open for enrollment year round. CHIP covers kids and teens with limited incomes, disabilities, and other circumstances. For more information on CHIP, go to www.InsureKidsNow.gov.
- To enroll, visit www.HealthCare.gov or call 1-800-318-2596. TTY users can call 1-855-889-4325. Customer service representatives are available 24 hours a day, 7 days a week. You can also call 1-877-KIDS-NOW (1-877-543-7669).
Health Insurance Marketplace
The Marketplace helps uninsured people find health coverage. There is a Special Enrollment Period (SEP) happening now though August 15, 2021. To enroll and for more information, go to www.HealthCare.gov or call 1-800-318-2596. TTY users can call 1-855-889-4325. Customer service representatives are available 24 hours a day, 7 days a week.
- Snapshots of what’s been happening within CMS.
- Archives of the National Medicare Education Program Meetings.
- Archives of the Long-term Services and Supports Open Door Forum.
- Free Medicare publications, Partner Publications & the CMS Product Ordering Website.
- Information on how to request CMS publications and documents in accessible formats.
Please send any questions/inquiries to the Partnership Mailbox at: Partnership@cms.hhs.gov.