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When Will My Daughter's Medicare Eligibility Start?

My daughter and I receive survivor benefits. When my daughter turned 16 in December 2020, I filed for disability for her, so that I could maintain my mother's insurance. She has significant intellectual issues. She was awarded disability in July of 2021, but I have not received an award letter. When I called to inquire about this last year, I was told she would be eligible for Medicare December of 2022. I just left my local SSA office to inquire about these issues, and they told me her MC eligibility begins December of 2022, because that's when she will convert to an Adult Disabled Child. They also said I should get her award letter next month. Finally, I set up a phone interview to continue to be her Rep. Payee, since she will be 18 in December. My questions are: when should she be eligible for Medicare? Is she eligible for any back pay once she converts to ADC status? What will they ask her in the Rep. Payee phone interview? Thanks so much.

Hi. According to Social Security's operations manual, the earliest that a disabled adult child (DAC) who hasn't been diagnosed with either Amyotrophic Lateral Sclerosis (ALS) or End Stage Renal Disease (ESRD) can qualify for Medicare is the month they reach age 20 ( There's a 24 month qualifying period for Medicare eligibility based on disability benefit entitlement, and since DAC entitlement can't begin prior to age 18, the 24 month qualifying period for DACs can't be completed prior to age 20. Therefore, barring some exception of which I'm unaware, it sounds like your daughter won't be eligible for Medicare until December 2024.

Turning age 18 and converting from child to DAC benefits won't change your daughter's benefit rate, nor will it result in any back pay. The paper representative payee application is an SSA-11-bk, and you review the questions on that form on the following government internet site:

Best, Jerry

Oct 14 2022 - 11:47am
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