Medicare and ALS Coverage: How-To Enroll, Eligibility and More

If you have ALS, know a loved one with ALS or are a caregiver for someone with ALS, it’s important to know how to navigate Medicare and what exactly is covered. Here’s a guide to Medicare and ALS coverage.

What is ALS?

Amyotrophic Lateral Sclerosis (ALS), also known as Lou Gehrig’s disease, is a progressive neurodegenerative disease that affects nerve cells in the brain and the spinal cord. The progression of ALS causes muscles to become weaker, increasing difficulty with movement, speech and other basic abilities such as chewing or swallowing. While treatments and therapies can’t reverse the damage of ALS, they can slow down the progression of symptoms, prevent complications and make the patient more comfortable.

Medicare Eligibility if You Have ALS

If you’ve been diagnosed with ALS, you are eligible for Medicare coverage the first month you receive Social Security Disability Insurance (SSDI) or a railroad disability annuity check. As soon as you are diagnosed with ALS, you’ll want to submit an application for SSDI to Social Security, as there is typically a five-month waiting period before disability benefits begin.

You’ll be automatically enrolled in Medicare Part A and Medicare Part B in the first month you begin receiving Social Security benefits, but you have the option to refuse automatic enrollment in Medicare Part B if you already have medical insurance. You also have the option to enroll in a Medicare Part D prescription drug plan to help cover any prescription drug expenses.

Medicare coverage for ALS: What benefits are available?

Medicare should cover home health care services as long as they are ordered by a doctor and are from one of the home health agencies that has been certified by Medicare. Skilled nursing care, physical, occupational and speech therapy, and home health aide services—services most ALS patients need—should also be covered with Medicare disability coverage.

SelectQuote Can Help Those With ALS Navigate Medicare Coverage

ALS can be a devastating disease for both those with it and their loved ones, and it’s important you get the care, coverage and support you need. At SelectQuote, we can help you navigate the complexities of Medicare disability coverage and make sure you have the coverage and benefits available to you.