02/23/2026
Medicare Coverage for Working People with Disabilities
Medicare eligibility for working people with disabilities falls into three distinct time frames. The first is the trial work period, which extends for 9 months after a disabled individual obtains a job. The second is the seven-and-three-quarter years (93 months) after the end of the trial work period. Finally, there is an indefinite period following those 93 months.(See the statute at 42 U.S.C. § 422(c), and regulation at 20 C.F.R. § 404.1592). Keep in mind that Medicare eligibility during each of these periods applies only while the individual continues to meet the medical standard for being considered disabled under Social Security rules.
Trial Work Period (TWP)
An individual who is receiving Social Security disability benefits is entitled to continue receiving Medicare as well as Social Security income during a maximum 9 month “trial work” period during any rolling 5 year time period. To qualify, an individual must have gross earnings of at least $770 per month in 2014, or work more than 80 hours of self-employment per month. The nine months of the trial work period do not necessarily have to be consecutive. During the trial work period, the ability to perform such work will not disqualify the individual from being considered disabled and receiving Social Security and Medicare benefits. However, independent evidence that the individual is no longer disabled could end benefits during the trial work period. After the nine month trial work period has ended, the work performed during it may be considered in determining whether the individual is no longer disabled, and thus no longer eligible for Social Security income and Medicare benefits.
Extended Period of Eligibility (EPE)
Individuals who still have the disabling impairment but have earned income that meets or exceeds the “Substantial Gainful Activity” level can continue to receive Medicare health insurance after successfully completing a trial work period. The Substantial Gainful Activity level for 2014 is $1070 a month, or $1,800 for the blind. This new period of eligibility can continue for as long as 93 months after the trial work period has ended, for a total of eight-and-one-half years including the 9 month trial work period. During this time, though SSDI cash benefits may cease, the beneficiary pays no premium for the hospital insurance portion of Medicare (Part A). Premiums are due for the supplemental medical insurance portion (Part B). If the individual’s employer has more than 100 employees, it is required to offer health insurance to individuals and spouses with disabilities, and Medicare will be the secondary payer. For smaller employers who offer health insurance to persons with disabilities, Medicare will remain the primary payer.
Indefinite Access to Medicare
Even after the eight-and-one-half year period of extended Medicare coverage has ended, working individuals with disabilities can continue to receive benefits as long as the individual remains medically disabled. At this point the individual – who must be under age 65 – will have to pay the premium for Part A as well as the premium for Part B. The amount of the Part A premium will depend on the number of quarters of work in which the individual or his spouse have paid into Social Security. Individuals whose income is low, and who have resources under $4,000 ($6,000 for a couple), can get help with payment of these premiums under a state run buy-in program for Qualified Disabled and Working Individuals.
