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Medicare Eligibility Overview

Medicare eligibility for disabled youths

Children may qualify for Medicare due to End-Stage Renal Disease or after receiving SSDI for 24 months. Other coverage options include S-CHIP and Medicaid.

Last Updated: March 28, 2025

If you have a child under the age of 20, they can only qualify for Medicare Medicare is the federal government health insurance program that provides health care coverage if you are 65 or older, are under 65 and receive Social Security Disability Insurance (SSDI) for 24 months, begin receiving SSDI due to ALS/Lou Gehrig’s Disease, or have End-Stage Renal Disease (ESRD) no matter your age. You can receive health coverage directly through the federal government (see Original Medicare) or through a private company (see Medicare Advantage).  if they have End-Stage Renal Disease (ESRD). Additionally, to qualify for Medicare coverage, the child must:

  1. Need dialysis Dialysis is the treatment used to artificially cleanse your blood of toxins when your kidneys no longer work. on a regular basis or require a kidney transplant
  2. And, have at least one parent who receives or is eligible for Social Security retirement benefits

Children over the age of 20 qualify for Medicare after receiving Social Security Disability Insurance (SSDI) Social Security Disability Insurance (SSDI) is a monthly benefit provided through the Social Security Administration for people who are unable to work because of a severe medical impairment (disability). People who receive SSDI for 24 months are eligible for Medicare.  benefits for at least two years (24 months). Your child may be able to receive SSDI, even with no work history, if they:

  1. Developed a disability A disability is any condition of the body or mind (impairment) that makes it more difficult for the person with the condition to do certain activities and interact with the world around them. The Social Security Administration (SSA) determines disability—and eligibility for Social Security Disability Insurance benefits (SSDI)—based on whether you can work and whether your disability is likely to be permanent. (Definition from the World Health Organization) before age 22
  2. Have at least one parent who receives Social Security retirement benefits
  3. And, are unmarried

If your child is 18 or younger and does not qualify for Medicare, they may qualify for your state’s Children’s health insurance Program (S-CHIP). S-CHIP is a program for families with low incomes. If your child is 19 or older, they may qualify for Medicaid.

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