My client is enrolled in Medicaid coverage and is currently receiving Social Security Disability Insurance (SSDI) benefits. Are they required to enroll in Medicare after they have received 24 months of SSDI benefits?

No, however individuals who have received 24 months of SSDI benefits will be automatically enrolled in Medicare Parts A and B when they begin receiving their 25th month of SSDI benefits. After auto-enrollment occurs, individuals can choose to keep or decline their coverage.

For Medicare Part A, individuals can:

• Keep their premium-free Medicare Part A coverage 
• Decline their Medicare Part A coverage, withdraw their original Social Security application, and pay back all Social Security cash benefits

For Medicare Part B, individuals can:

• Keep their Medicare Part B coverage and pay a premium
• Decline Medicare Part B coverage and avoid a late enrollment penalty later if they have qualifying coverage
• Decline Medicare Part B coverage and pay a late enrollment penalty later if they do not have qualifying coverage 

In such cases, it is advantageous for clients to enroll in one or more Medicare Parts (especially premium-free Part A) if the client needs or wants assistance with Medicare cost-sharing (through Medicare Savings Programs), prescription drug cost-sharing (through the Extra Help program), and behavioral health and/or long-term care costs.