Helping People With Disabilities Nationwide

The Interplay of Medicaid, Medicare, SSDI and SSI

by | Mar 9, 2012 | SSD - Social Security Disability Process And Benefits |

What healthcare resources will you have if you are on SSI or SSDI? If you apply for Social Security Disability Insurance (SSDI), can you still receive Medicaid? How long does it take to get on Medicare after you apply for SSDI?

In most situations, if you are eligible for SSI, you will be eligible for Medicaid. If you are eligible for Social Security Disability and receive SSD payments for two years, you will receive Medicare. In unique circumstances, you may be eligible for both SSI and SSDI. In those cases, it is less clear whether you will receive Medicaid and/or Medicare.

There are also exceptions. For example, under the Employment for Disabled Americans Act of 1986, adult children who were disabled before they reached 22 years old may continue to receive Medicaid when they switch from SSI to SSDI. Of course, if those children receive income from other sources than their SSDI, they may lose their eligibility for Medicaid.

As you can see, the interplay of Medicaid, Medicare, SSDI and SSI is complicated. We recommend speaking with an experienced benefits lawyer to better understand your options.

Medicaid and SSI: Medicaid is a federal-and-state health insurance program available for low income individuals. In most states, if you are eligible for Supplemental Security Income (SSI) benefits, you are eligible for Medicaid. However, in Minnesota, there are separate eligibility rules for Medicaid (called medical assistance or “MA”) and you must file a separate application.

Generally, individuals are eligible for Medical Assistance and SSI if they are state residents with little income and assets who are 65 years of age or older, blind or disabled.

Medicare and Social Security Disability: Social Security Disability is available to individuals who have worked Social Security-eligible jobs and who fall under the Social Security Administration’s definition of disability. Individuals are eligible if they are not able to do the work they did before and will be unable to adjust to another job due to their condition. The disability must also last for at least one year or be terminal.

The Social Security Administration automatically enrolls individuals in Medicare coverage after they have received disability benefits for at least two years. Medicare covers hospital insurance as well as medical insurance.

Source: Social Security Administration, “Medicare Coverage if You’re Disabled.”



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