It is not unusual for a Social Security disability claimant to be approved by an Administrative Law Judge (ALJ) and to be immediately eligible for Medicare, despite what amounts to a two and a half year waiting period for Medicare. After some problems in the latter part of last year, Social Security is paying cash benefits relatively promptly after a favorable ALJ decision. However, it has always taken significantly longer for the Medicare card to come in. Why? It's not unusual for a claimant to have an urgent need for that Medicare card. I know that the award certificates in these cases say that the award certificate itself can be used in lieu of a Medicare card but I've heard of providers refusing to accept the award certificate as proof of entitlement to Medicare. For that matter, the award certificates come out slower than the payment of benefits. I know that I can send a claimant to their local field office and someone there may be kind enough to give them something in writing saying they are eligible for Medicare but sometimes they refuse to do this and providers won't always accept it. Why does it take so long to print and mail a Medicare card? Are retirees subjected to the same delays? I've never understood why the Medicare card isn't mailed at the same time as the award certificate.