Medicare Advantage Plans for People Under 65 With Disabilities: 2027 Guide

Reviewed by Russell Noga, Licensed Medicare Insurance Broker (all 50 states) — Last updated October 30, 2026

Yes, you can join a Medicare Advantage plan before age 65 if you have Medicare because of a disability, ALS or end-stage renal disease (ESRD). You get the same plan choices, at the same premiums, as people who are 65 or older in your county. Plans cannot charge you more because of your age or your health.

That matters because the other main route, Original Medicare with a supplement, is much harder to get under 65 in many states. Below is how Medicare Advantage works for younger enrollees, which special needs plans may fit, and what our analysis of CMS 2027 plan data shows about where those plans are sold.

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How People Under 65 Qualify for Medicare

How you qualify	When Medicare starts	Can you join Medicare Advantage?
Social Security Disability Insurance (SSDI) or Railroad Retirement disability	After 24 months of disability benefits	Yes, during your Initial Enrollment Period and each fall Open Enrollment
ALS (Lou Gehrig’s disease)	The month your disability benefits begin, with no 24-month wait	Yes
End-stage renal disease (kidney failure on dialysis or after a transplant)	Usually after a waiting period tied to dialysis or transplant	Yes. Since January 1, 2021, people with ESRD can join any Medicare Advantage plan that serves their area

Source: Medicare.gov; Social Security Administration; 21st Century Cures Act (ESRD Medicare Advantage eligibility, 2021).

Your first chance to choose a plan is your Initial Enrollment Period, the seven months around your 25th month of disability benefits. After that, you can switch during Medicare Open Enrollment, October 15 to December 7, or the Medicare Advantage Open Enrollment Period, January 1 to March 31.

Medicare Advantage under 65 in 2027: 1,050 dual special needs plans in 97% of counties, 752 chronic condition special needs plans, 38 states with under-65 supplement rules, $2,400 Part D cap

Why Medicare Advantage Is Often the Practical Choice Under 65

Original Medicare has no out-of-pocket limit, so most people want something to cover the gaps. Under 65, the usual fix is harder to get:

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Federal law does not require insurers to sell Medicare supplement policies to people under 65. Rules are set by each state.

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38 states have some requirement, but they vary widely. A June 2026 MedicareResources.org review found 12 states only require insurers to offer one plan, 10 require guaranteed issue but allow much higher premiums for under-65 enrollees, and 16 require guaranteed issue with limits on under-65 premiums.

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ESRD can be excluded. California, Vermont and Massachusetts carve out people with ESRD from some or all of these protections.

Medicare Advantage works differently. Every standard plan must accept anyone with Medicare Parts A and B who lives in its service area (special needs plans add their own eligibility rules), and the premium is the same for every member of the plan. Each plan also has a yearly in-network out-of-pocket limit. Compare the two routes in more detail in our Medigap vs Medicare Advantage guide.

Special Needs Plans That May Fit Younger Enrollees

Many people under 65 qualify for a special needs plan (SNP), a type of Medicare Advantage plan built around a group’s needs. Each type has its own eligibility test:

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Dual special needs plans (D-SNPs) are for people with both Medicare and Medicaid. CMS reports about 12.0 million dual-eligible enrollees nationwide as of April 2026, 17.1% of everyone on Medicare.

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Chronic condition special needs plans (C-SNPs) are for people with qualifying conditions such as diabetes, chronic heart failure, ESRD, and some neurologic and mental health conditions. Plans may include care coordination and drug lists matched to the condition.

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Institutional special needs plans (I-SNPs) are for people who live in a nursing home or need that level of care at home.

Our analysis of CMS 2027 plan data

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1,050 D-SNPs are sold for 2027, in 3,040 of 3,131 counties (97%).

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752 C-SNPs are sold in 2,433 counties (78%) across 46 states.

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Florida (129) and Texas (118) have the most D-SNPs; New York and California have 50 each.

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36% of all 2027 individual Medicare Advantage plans are special needs plans (1,965 of 5,481).

Learn how each type works in our guide to Medicare Advantage special needs plans.

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Dual special needs plans by state for 2027: Florida 129, Texas 118, New York 50, California 50, Georgia 39, Pennsylvania 39

Where Dual Special Needs Plans Are Sold in 2027

D-SNP choices vary a lot by state. These carriers sell the most D-SNPs nationwide for 2027:

Carrier	2027 D-SNPs
UnitedHealthcare	214
Humana	132
Aetna Medicare	110
Wellcare	97
Devoted Health	78
HealthSpring	37

Source: our analysis of CMS 2027 Plan Benefit Package files, individual plans only.

In some states, D-SNPs are tied to your Medicaid plan, so you may need to pick a D-SNP from the same company that runs your Medicaid coverage. Ask your state Medicaid office or a licensed agent which plans are coordinated with your Medicaid benefits. Carrier examples include UnitedHealthcare Dual Complete and Aetna dual special needs plans.

Help With Costs If You're on SSDI

Many people on SSDI have limited income, and several programs work alongside a Medicare Advantage plan:

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Medicare Savings Programs may pay your Part B premium, which is $202.90 a month in 2026, and in some cases your deductibles and copays. Apply through your state Medicaid office.

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Extra Help lowers Part D premiums and drug copays. If you get Medicaid or a Medicare Savings Program, you usually qualify automatically.

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The 2027 Part D cap limits out-of-pocket costs for covered drugs to $2,400 for the year, which matters for people with high-cost medications.

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$0 premium plans are widely available, but you still pay the Part B premium unless a program pays it for you.

If you have Medicaid and Medicare, your Medicare Advantage costs may be much lower. See how in our guide to $0 premium Medicare Advantage plans.

What Changes When You Turn 65

Turning 65 gives younger enrollees a second set of choices:

A new Medicare enrollment window. You get another chance to join or switch Medicare Advantage and drug plans around your 65th birthday.

A federal supplement open enrollment period. For six months starting the month you turn 65, you can buy any Medicare supplement policy sold in your state without health questions, even if you were turned down before.

Any late enrollment penalty may end. If you paid a Part B late penalty under 65, it generally stops once you qualify by age.

Mark the date a few months ahead so you can compare both routes before your birthday month.

Who Medicare Advantage Fits Under 65

A good fit if you:

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Live in a state where Medicare supplements are expensive or unavailable under 65

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Have Medicare and Medicaid and can use a D-SNP

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Have a condition that qualifies for a C-SNP

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Want a yearly out-of-pocket limit and drug coverage in one plan

Look harder at other options if you:

See specialists outside your area or travel often for care

Need a specific hospital or center that few local plans include

Expect to need many prior authorizations for ongoing treatment

Check your doctors, drugs and specialists in each plan’s 2027 network before you enroll.

Compare 2027 Medicare Advantage Plans for People Under 65

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Medicare Advantage Under 65 With a Disability — Frequently Asked Questions

➤ Can you get a Medicare Advantage plan if you are under 65 and on disability?

Yes. If you have Medicare Parts A and B because of a disability, you can join any Medicare Advantage plan that serves your area, during your Initial Enrollment Period or a later enrollment window.

➤ Do Medicare Advantage plans charge more for people under 65?

No. Every member of a Medicare Advantage plan pays the same premium, whatever their age or health.

➤ Can I join Medicare Advantage if I have ESRD?

Yes. Since January 1, 2021, people with end-stage renal disease can join any Medicare Advantage plan in their area.

➤ Why is it hard to get a Medicare supplement under 65?

Federal law does not require insurers to sell supplements to people under 65. State rules vary, and in some states premiums for under-65 enrollees are much higher.

➤ How many dual special needs plans are available for 2027?

Our analysis of CMS 2027 plan files counts 1,050 D-SNPs, sold in 97% of U.S. counties.

➤ Can someone on SSDI get help paying the Part B premium?

Possibly. Medicare Savings Programs, run by state Medicaid offices, may pay the Part B premium for people with limited income and assets.

➤ What happens to my Medicare Advantage plan when I turn 65?

You can keep it. Turning 65 also gives you a new chance to change plans and a six-month window to buy a Medicare supplement without health questions.

➤ Is there a waiting period for Medicare with ALS?

No. People with ALS get Medicare the month their Social Security disability benefits begin.

New to Medicare?

If you are new to Medicare, then you can enroll in a 2027 Medicare Advantage plan up to three months prior to your Medicare Part B effective date.

Call one of our licensed insurance agents to see what the best time frame is for you to enroll, based on your current situation. You can contact them at 1-855-454-9051 (TTY 711), Mon–Fri 8am–9pm EST.

Have Questions?

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Russell Noga

Russell Noga is the Founder & CEO of Medisupps.com and the founder of CompareMedicareAdvantage.org. A Medicare insurance broker licensed in all 50 states with 18 years in the industry, he works with other licensed agents and partners to keep plan information accurate and current for the 2027 Medicare Advantage enrollment season and beyond.

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Medicare Advantage Plans for People Under 65 With Disabilities: 2027 Guide

Compare 2027 Medicare Advantage Plans for People Under 65

Speak with a licensed insurance agent

1-855-454-9051TTY 711

Mon-Fri: 8am-9pm ET

How People Under 65 Qualify for Medicare

Why Medicare Advantage Is Often the Practical Choice Under 65

Special Needs Plans That May Fit Younger Enrollees

Compare 2027 Medicare Advantage Plans for People Under 65

Speak with a licensed insurance agent

1-855-454-9051TTY 711

Mon-Fri: 8am-9pm ET

Where Dual Special Needs Plans Are Sold in 2027

Help With Costs If You're on SSDI

What Changes When You Turn 65

Who Medicare Advantage Fits Under 65

Compare 2027 Medicare Advantage Plans for People Under 65

Speak with a licensed insurance agent

1-855-454-9051TTY 711

Mon-Fri: 8am-9pm ET

Medicare Advantage Under 65 With a Disability — Frequently Asked Questions

➤ Can you get a Medicare Advantage plan if you are under 65 and on disability?

➤ Do Medicare Advantage plans charge more for people under 65?

➤ Can I join Medicare Advantage if I have ESRD?

➤ Why is it hard to get a Medicare supplement under 65?

➤ How many dual special needs plans are available for 2027?

➤ Can someone on SSDI get help paying the Part B premium?

➤ What happens to my Medicare Advantage plan when I turn 65?

➤ Is there a waiting period for Medicare with ALS?

New to Medicare?

Have Questions?

Speak with a licensed insurance agent

1-855-454-9051

TTY users 711

Mon-Fri: 8am-9pm ET

Compare plans & benefits in your area

Or speak with a licensed insurance agent

1-855-454-9051TTY 711

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