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US · guidance

CMS Pub. 100-01, ch. 2, § 10.3

Hospital Insurance for Disability Beneficiaries

activein force · 2026-08-25 – presentas-observed

A disabled person who is entitled to social security or railroad retirement benefits on the

basis of disability is automatically entitled to HI after 24 months of entitlement to such

benefits. Since there is a 5-month disability benefits waiting period, the person actually

becomes entitled to HI after being disabled for 29 months.

In addition, disabled persons who are not insured for monthly Social Security disability

benefits but would be insured for such benefits if Government QCs were treated as social

security QCs, are deemed to be entitled to disability benefits and automatically entitled to

HI after being disabled for 29 months.

The months in the Medicare qualifying period need not be consecutive so that months

from a previous period of disability benefit entitlement generally may be counted in

determining when the qualifying period requirement is met. HI entitlement on the basis

of disability is available not only to the worker, but to the widow, widower, or child of a

deceased, disabled, or retired worker if any of them become disabled within the meaning

of the Social Security or Railroad Retirement Acts.

If an individual recovers from a disability, HI entitlement ends with the month after the

month he or she is notified of the disability termination. For example, if notification is

November 15, entitlement ends December 31. However, if the individual's disability

benefit entitlement ends only because he or she was working, HI entitlement may

continue for up to 78 additional months.

History

(Rev. 1, 09-11-02)

Provenance

Source
cms.gov
Retrieved
2026-08-25
Edition
iom-2026-08-25
Content hash
96b02c9aa0f70304c4d36260cecb1c4b1c844c5881307d0eda57c50e6b0d5799
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