An award of disability benefits under the Social Security disability insurance program comes with Medicare insurance. But not right away. Rather, the insurance begins two years after your date of entitlement. Your date of entitlement is your onset date plus the 5 month Title II waiting period.
In a typical disability case, that waiting period may not matter. Often claimants are out of work for a while before they apply for disability benefits, and if the claim is initially denied, two years from the date of entitlement may pass before a hearing is held and a decision issued.
But for claimants with the most serious and life-threatening medical conditions, the medical insurance is a necessary part of the program. For those claimants, the 24 month waiting period can present a tremendous hardship.
Waiting two years for Medicare insurance benefits has a tremendous human cost for those who are too sick to work, too soon for Medicare. Fortunately, fixing this problem is the topic of ongoing political discussion.