Hi Larry,

Our disabled adult child (DAC) started collecting SSDI at age 34. She is currently receiving Medicaid, which allows her to attend a special needs program under a Medicaid waiver. She will be eligible for Medicare after being on SSDI for two years (next year at age 36). We don't want to jeopardize the benefits she's receiving under the Medicaid waiver, so we're hesitant to put her on Medicare at that time. Is there a timeframe around her 36th birthday where she is required to enroll in Medicare, or can she enroll in it when she is older without penalty?

Thanks,

Vincent

Hi Vincent. Yes and no. Part B of Medicare is optional, and you aren't required to ever enroll in Part B of Medicare.
You can only apply for Part B of Medicare during Medicare enrollment periods. Your daughter's initial enrollment period (IEP) for Part B would start 3 months prior to her 25th month of Social Security disability (SSDI) benefit entitlement, and continue through the end of the 28th month of her SSDI entitlement. If your daughter doesn't enroll in Part B of Medicare in her IEP then she could only apply in a subsequent general enrollment period (GEP).

GEPs occur annually from January 1 through March 31, and if you apply for Part B during a GEP your Part B coverage starts on July 1st of the year of your enrollment. Also, you must pay a 10% premium surcharge for each 12 month period that you don't enroll in Part B after your IEP ends.

Part A of Medicare isn't optional, though, and your daughter will be automatically enrolled in Part A of Medicare starting with the first day of her 25th month of SSDI entitlement. I'm not an expert on the Medicaid program, so I can't give you any advice on what you should do. Before deciding not to enroll your daughter in Part B of Medicare, though, I would strongly suggest discussing your options with the agency that administers her Medicaid benefits.

Best, Jerry