01/11/2026
Medicare Benefits are Available for People with Disabilities
Medicare coverage is the same for people who qualify based on disability as for those who qualify based on age. For those who are eligible, the full range of Medicare benefits are available. Coverage includes certain hospital, nursing home, home health, physician, and community-based services. The health care services do not have to be related to the individual’s disability in order to be covered.
People with Dementia, Mental Illness, and Other Long-Term and Chronic Conditions CAN Obtain Coverage
There are no illnesses or underlying conditions that disqualify people for Medicare coverage.
Beneficiaries are entitled to an individualized assessment of whether they meet coverage criteria.
Although there are criteria that must be met to obtain coverage for particular kinds of care, Medicare should not be denied based on the person’s underlying condition, diagnosis, or other “Rules of Thumb.” For example:
Beneficiaries should not be denied coverage simply because they will need health care for a long time.
Beneficiaries should not be denied coverage simply because their underlying condition will not improve.
Coverage should NOT be denied simply because services are “maintenance only” or because the patient has a particular illness or condition (See the Jimmo v. Sebelius Summary, below).
Physical therapy and other services can be covered even if they are only expected to maintain or slow deterioration of the person’s condition, not to improve it.
People with certain conditions are at particular risk for being unfairly denied access to Medicare coverage for necessary health care.