Social Security and Medicare FAQs

Am I eligible to apply for Social Security Disability benefits?

If you have worked in employment covered by Social Security for a certain period of time before you become disabled, you may apply for Social Security Disability benefits.  The amount of time you must have worked depends on your age.  Currently, if you are age 31 or over, you must have worked in covered employment for five years or more, earning more than a minimum amount that changes from year to year, before the onset of your disability.  Different rules apply if your disability is blindness.

Social Security pays only for total disability.  No benefits are payable for partial disability or for short-term disability.  “Disability” under Social Security is based on your inability to work.  You are considered disabled under Social Security rules if—

  • You cannot do work that you did before
  • You cannot adjust to other work because of your medical condition(s)
  • Your disability has lasted or is expected to last for at least one year or to result in death.

Social Security does not pay benefits for the first five months of your disability.  You can apply for benefits before the end of five months after your disability begins, but you will not receive benefits until the sixth month after the onset of your disability.

How much will I receive and for how long?

The amount of your benefits depends upon your prior earning history, which is maintained by the Social Security Administration.  There is no limit on the time you can receive Social Security Disability benefits in Illinois, except that they will automatically be converted to Social Security Retirement benefits when you reach your normal retirement age.  If your condition changes and you are able to return to work, your benefits may continue for some time to be sure you are able to maintain your reemployment. Your status will be reviewed periodically by the Social Security Administration.  If your benefits are denied or terminated, you have the right to appeal that determination. Helping clients with disability in Illinois and throughout the Midwest.

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What does Medicare pay for?

Medicare Part A (Hospital Insurance) helps cover your inpatient care in hospitals, critical access hospitals, and skilled nursing facilities.  It also covers hospice care and some home health care after you meet certain conditions.  Medicare Part B (Medical Insurance) helps cover your doctors’ services, outpatient hospital care, and some other medical services that Part A does not cover, such as some of the services of physical and occupational therapists, and some home health care.  Part B helps pay for these covered services and supplies when they are medically necessary.  You pay the Medicare Part B premium.

Am I eligible for Medicare if I am disabled but under 65 years old?

Generally, Medicare is available for people younger than 65 with disabilities or End Stage Renal Disease (permanent kidney failure requiring dialysis or transplant).  If you are under age 65, you can get Medicare Part A benefits without having to pay premiums if —

  • You have been entitled to Social Security or Railroad Retirement Board disability benefits for 24 months.  (Note: If you have Lou Gehrig’s disease, your Medicare benefits begin the first month you get disability benefits.)
  • You are a kidney dialysis or kidney transplant patient.

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