Medicare for disabled adult child - waiting 2 years after starting my Social Security retirement?
I'm really confused about Medicare eligibility for my disabled son (age 38). I've been collecting my retirement benefits for about 14 months now, and when I contacted Social Security last week about getting him on Medicare, the representative told me he can't qualify until I've been on Social Security for at least 2 full years. That doesn't sound right to me... I thought disabled adult children could get Medicare through their parent's work record once the parent starts collecting. Does anyone know if this 2-year waiting period is actually correct? I'm worried because his current insurance is terrible and he desperately needs better coverage for his treatments.
16 comments
Connor O'Brien
The SSA rep is confusing two different rules. For a disabled adult child (what SSA calls a Disabled Adult Child or DAC), they can receive BENEFITS on your record when you start collecting retirement, but Medicare eligibility works differently. Your son would need to be approved for DAC benefits first, and then there's typically a 24-month waiting period from his first disability benefit payment before Medicare begins - it's not tied to how long YOU'VE been collecting. Has your son been approved for DAC benefits yet?
0 coins
StarSailor
•Thank you! No, he hasn't been approved for DAC benefits yet. I didn't realize that was a separate process. Do we need to file an application specifically for that? The rep didn't mention anything about this when I called.
0 coins
Yara Sabbagh
I went through this exact thing with my daughter!!!! The SS office told me WRONG information THREE TIMES!! They kept saying different things each time I called. Your son needs to apply for DAC (Disabled Adult Child) benefits first, then after he's approved there's a 24 month waiting period for Medicare. BUT the 24 months starts from when he's eligible for DAC, not necessarily from when he applies!!! So get him applied ASAP!!
0 coins
Keisha Johnson
•this happened to my nephew too, SS people don't even understand their own rules sometimes lol
0 coins
Paolo Rizzo
To clarify the process: Your adult disabled son needs to file for Childhood Disability Benefits (CDB, also called Disabled Adult Child benefits) on your record. There's Form SSA-4-BK for this. Once approved, there's a 24-month waiting period before Medicare starts. The wait begins from his entitlement date, not your retirement date. Also important: your son must have become disabled before age 22 to qualify. If you haven't filed for the CDB yet, that's step one.
0 coins
StarSailor
•This is incredibly helpful. No one at SSA explained this process to me. My son's disability began when he was 19, so it sounds like he should qualify. Is there any way to expedite this 24-month waiting period? His current insurance barely covers anything.
0 coins
QuantumQuest
I had to call SSA about 15 times before I finally got someone who knew what they were talking about with my disabled daughter's Medicare. The phone lines are absolutely terrible - I'd wait 2+ hours just to get disconnected. Finally I tried this service called Claimyr (claimyr.com) that got me through to an agent in about 20 minutes instead of hours. They have a demo video at https://youtu.be/Z-BRbJw3puU that shows how it works. Saved me so much frustration when dealing with the DAC application process. Might be worth checking out since you'll probably need to call SSA multiple times to get this sorted.
0 coins
Amina Sy
•did this actually work? i'm always skeptical of services like this but i've been trying to reach SSA for 2 weeks about my benefits and keep getting disconnected
0 coins
QuantumQuest
•Yes, it actually did work for me. I was skeptical too but was desperate after getting disconnected three days in a row. They got me through to an agent who helped file my daughter's DAC application correctly. Definitely worth it to avoid the endless hold music!
0 coins
Keisha Johnson
my cousin had to do this for her son and the wait sucks but nothin u can do about it. make sure u have ALL his medical records going back to when he was 19 showing the disability. SS is super picky about proof! good luck
0 coins
Oliver Fischer
There are some exceptions to the 24-month Medicare waiting period though! If your son has End-Stage Renal Disease or ALS, the waiting period is waived. Also, if he was previously entitled to benefits that were terminated, and he becomes entitled again within 5 years, any previous months of entitlement count toward the 24 months.
0 coins
StarSailor
•He doesn't have either of those conditions unfortunately. He has severe schizophrenia that developed when he was 19. I appreciate the information though - it's helpful to know what the exceptions are.
0 coins
Yara Sabbagh
ALSO!!! I forgot to mention - while you're waiting for Medicare to kick in, check if your state has a Medicaid program for disabled adults! My daughter qualified for Medicaid during the Medicare waiting period and it helped SOOO much with her medical bills!!!
0 coins
Amina Sy
•this is good advice 👍 medicaid saved us big time during the wait
0 coins
Connor O'Brien
One more thing to consider: Once your son is approved for DAC benefits, he might be eligible for SSI (Supplemental Security Income) during the Medicare waiting period if his income and resources are low enough. SSI recipients automatically qualify for Medicaid in most states, which could help with healthcare costs while waiting for Medicare. You should specifically ask about this when you call SSA about the DAC application.
0 coins
StarSailor
•Thank you for this suggestion! I'll definitely ask about SSI when we apply for the DAC benefits. He has very little income and resources, so this might be an option for us. I really appreciate everyone's help - I feel much better informed now than after talking to the SSA representative.
0 coins