Does Medicare or Medicaid Come with Disability?

If you're approved for disability benefits, you'll also get Medicare or Medicaid, depending on whether you receive SSDI or SSI benefits.

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Disabled people who are approved for Social Security disability insurance (SSDI) benefits will receive Medicare, and those who are approved for Supplemental Security Income (SSI) will receive Medicaid. However, SSDI recipients aren't eligible to receive Medicare benefits until two years after their date of entitlement. For more information on calculating how this is calculated, see our article on when you'll receive Medicare benefits. There is no waiting period for SSI recipients to receive Medicaid.

Medicaid for SSI Recipients

In most states, when a disabled person is approved for SSI, they are also automatically approved for Medicaid benefits. There are a few states, inlcuding Illinois and Ohio, that are exceptions to this rule. These states may have a lower income or asset limit for the Medicaid program than the SSI program, so they make their own Medicaid determinations.

Medicare for SSI Recipients?

Do you get Medicare coverage if you were approved for SSI? Claimants who are approved for SSI only typically receive Medicaid coverage in most states. And like SSI, Medicaid is subject to income and asset limitations. Medicaid is a needs-based, state- and county-administered program that provides for a number of doctor visits and prescriptions each month, as well as nursing home care under certain conditions.

Can you ever get Medicare if you get SSI? Medicare coverage for SSI recipients does not occur until an individual reaches the age of 65 if they were only entitled to receive monthly SSI disability benefits. At the age of 65, these individuals are able to file an uninsured Medicare claim, which saves the state they reside in the cost of Medicaid coverage. Basically, the state pays the medical premiums for an uninsured individual to be in Medicare so that their costs in health coverage provided through Medicaid goes down. 

For people with limited income and assets, Medicare offers "Extra Help" for prescription drug costs. This Extra Help covers the costs of a Medicare prescription drug plan -- including monthly premiums and prescription co-pays. The application is online at www.socialsecurity.gov/prescriptionhelp.

SSI and SSDI Eligibility?

Some disability recipients will be approved for concurrent benefits; that is, they will draw disability money from both SSDI and SSI. In such instances, the issue of whether a claimant will get Medicare or Medicaid is not so cut and dry. Therefore, claimants who are approved for concurrent disability benefits should consult their local Social Security office regarding their Medicare/Medicaid eligibility.

Learn more about the benefits that come with Social Security disability.

Updated by: , J.D.

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