If I Get Social Security Disability, Will I Get Health Care Benefits?

You can get health insurance if you're approved for disability benefits along with your monthly cash payments. If you're awarded Social Security Disability Insurance (SSDI) you can usually get Medicare, while Supplemental Security Income (SSI) often makes you eligible for Medicaid. Enrollment isn't necessarily automatic, however. Even if you're approved for SSDI, you'll typically need to wait 24 months from your date of entitlement before you can start getting Medicare, and SSI enrollment procedures depend largely on the state where you live. 

Your Social Security notice of award should contain a section discussing your eligibility for medical insurance. This section should include information on your Medicare waiting period (if you're approved for SSDI) or how you can get your Medicaid coverage started (if you're approved for SSI). Because the terminology Social Security uses can get confusing, it's a good idea to get some basic understanding of the various disability programs as well as how they interact on the state and federal levels. 

What Kind of Health Insurance Comes With Social Security Disability?

What most people think of as “Social Security disability” is actually two programs, SSDI (which comes with Medicare) and SSI (which comes with Medicaid). The type of program you’re approved for depends on factors such as your current financial situation and your past employment record. SSDI is available to people who've earned enough work credits to become fully insured under the program, while SSI is needs-based and subject to certain  income and asset limits.

You can't get SSDI (and therefore Medicare) if you haven't worked in a very long time, but SSDI doesn't have any asset limits. SSI and Medicaid are available to disabled adults even if they've never worked, but you'll need to have very low income and resources in order to qualify. Your Social Security award letter will tell you whether you qualify for Medicare or Medicaid in the section labeled “Information About Medicare” or “Information About Medicaid.”

Am I Enrolled in Medical Insurance With SSDI or SSI After Approval?

You aren't typically enrolled in medical insurance immediately after you've been approved for SSDI or SSI. Even though you qualify, it’s likely that you’ll have to go through additional administrative steps before you’re officially covered. And depending on the date your disability started, you might have to wait before Social Security gives you the green light to enroll.

When Does Medicare Start After SSDI Approval?

The big thing to be aware of for SSDI is that your health insurance (Medicare) won't kick in until 24 months after your "date of entitlement." Your date of entitlement is the date that the Social Security Administration begins to owe you money. Broadly speaking, your entitlement date is five months after your disability onset. 

Originally intended as a cost-saving measure, this 24-month waiting period might leave a gap in your health care if you aren’t otherwise insured. But check your award letter for your exact entitlement date. If it's more than two years before the date of your award notice, you won't need to go through the waiting period before you can start receiving Medicare. (For more information, see our article on how long it takes to get Medicare coverage through SSDI.) 

Keep in mind that even though you’re eligible for Medicare, you’ll need to pay premiums just as you would for private health insurance. Social Security will deduct your premiums from your monthly benefit check, but if you don’t want Medicare, you can opt out.

Does SSI Automatically Come With Medicaid?

An application for SSI doubles as an application for Medicaid in most states, so if you’ve been awarded SSI benefits you can start getting medical insurance right away. You don't need to wait 24 months to access health insurance, but you might need to jump through some bureaucratic hoops to begin your Medicaid coverage. Because Medicaid is administered by your state’s health department, each state has different procedures for enrollment. Some states have separate applications for SSI and Medicaid, so you may need to submit an additional application for Medicaid. In a handful of states, Medicaid coverage isn’t guaranteed, but most people who get SSI are eligible.

What If I Need Health Insurance Before Medicare Starts?

If you lost employer-provided health insurance because of your disability, you may qualify for an 11-month extension of COBRA coverage. (COBRA is a federal law that allows you to continue your employer-provided health care plan while paying premiums at the group rate.) COBRA normally lasts for 18 months after you lose your job, but if Social Security finds you disabled, you can get an 11-month extension for a total 29 months of coverage. Ideally, this extension can bridge the gap between when you stop working and when Medicare begins. 

You can also try to get on Medicaid before your Medicare kicks in, but keep in mind that you'll generally need to have low income and resources to qualify. (Check out our article on how SSDI affects your Medicaid eligibility for more details.) If you don't meet your state's Medicaid requirements, you can look for an affordable plan on the health insurance marketplace ("Obamacare"). Another option is to have a spouse or other family member add you to their employer insurance policy, if they have one. 

What to Do If Your State Requires a Separate Medicaid Application

If your state requires a separate application to enroll in Medicaid, you should apply promptly through your state's Medicaid agency after you receive your SSI award letter. Some states will consider you eligible for Medicaid once you've been awarded SSI so it's just a matter of submitting the application form, but others have stricter requirements for Medicaid and can even deny the Medicaid application even if you receive SSI. You can appeal a Medicaid denial, however.  

Getting Legal Help For Your SSDI or SSI Application

You don't need to get an attorney in order to get Medicare or Medicaid if you've already been approved for disability benefits, since you'll either be enrolled automatically or can fill out the needed paperwork yourself. But if you're ready to submit your initial application for disability benefits (or you've already applied but been denied), you may want to consider speaking with an experienced disability attorney who can help you strengthen your case, particularly if you've been scheduled for a disability hearing. Disability attorneys work on contingency, meaning they don't get paid unless (and until) you win, and many offer free consultations, so it doesn't hurt to ask around to find a lawyer who you feel comfortable working with.