Medicare Coverage for Epilepsy electrical activity in brain

Medicare coverage for Epilepsy

Medicare Coverage for Epilepsy electrical activity in brain

You can get Medicare coverage for epilepsy when you turn age 65 or before age 65 when a disability limits your physical and mental functioning. Social Security has specific epileptic requirements that qualify you for the disability. Read this article to discover:

Estimated reading time: 4 minutes

What is Epilepsy?

Healthline says, “Epilepsy is a chronic disorder that causes unprovoked, recurrent seizures.” Social Security describes two types of seizures and the frequency that may qualify you for disability.

  • Generalized tonic-clonic seizures occur once a month for at least three consecutive months despite adherence to prescribed treatment. This type of seizure is also called Grand Mal and involves a loss of consciousness and violent muscle contractions known as convulsions.  
  • Dyscognitive seizures occur at least once a week for at least three straight months despite adherence to prescribed treatment. This type goes by many names such as partial, focal, absence seizure. For example, the person may appear to be staring off into space for a few seconds. 
Medicare coverage for Epilepsy senior woman convulsion
Senior woman has a Grand Mal convulsive seizure.

Having Alzheimer’s disease can increase your risk of seizures.

Alzheimer’s and Your Risk of Seizures

According to the Alzheimer’s Society, people with dementia such as Alzheimer’s “are at risk of having epileptic seizures.” Dr. Alzheimer described this seizure risk himself in 1911. Recent research suggests seizures can occur early-on in Alzheimer’s disease. A research study showed about “1 in 8 patients with dementia described episodes which we believe could have been epileptic seizures.”

So why do people with Alzheimer’s have a higher risk of seizures?

Medicare coverage for Epilepsy senior man blank stare copy
Normal brain vs Alzheimer brain

Increased Risk for Seizure

Anything that changes the structure of your brain, such as Alzheimer’s, can cause seizures. Two proteins in Alzheimer’s disease, “amyloid and tau,” build up in your brain and “affect how the brain nerve cells communicate with each other.” In some cases, “these nerve cells can become ‘hyper-excitable.’ ” As a result, these neurons “behave uncontrollably, causing epileptic seizures.”

Now you know why people with Alzheimer’s have an increased risk for seizures, so when does Medicare cover epilepsy?

Medicare Coverage for Epilepsy

According to, Medicare covers people under age 65 who are eligible for Social Security Disability Insurance (SSDI) after a 24-month waiting period. However, if you had a disabling impairment that began two or more years before becoming eligible for SSDI, you will automatically be enrolled in Medicare. Otherwise, you will have to wait two years before Medicare automatically enrolls you.

Fifty year old bald man wears eye glasses - Medicare coverage for epilepsy

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Last Updated on January 25, 2021 by Brian Kondas