If you’re considering applying for Social Security disability benefits and are currently on Medicaid, you may be wondering what will happen to your health insurance if you get approved. 

Will you get to keep your current benefits? Will you have to pay out of pocket for a new health insurance plan? 

With the cost of American healthcare constantly on the rise, many applicants worry that qualifying for disability will ultimately cost them in the long run. In this post, Social Security Disability Advocates USA clears up some common misconceptions about Medicaid and disability and explains how to get the coverage you need.

The Difference Between Medicaid and Medicare

Before proceeding, it’s important to understand the difference between Medicaid and Medicare. Medicaid is a federal government assistance program managed by individual states. It helps low-income individuals and families by providing free or very low-cost healthcare coverage. 

Medicare, on the other hand, is a federal government assistance program run by the federal government. It provides Americans who are over the age of 65 and/or have a qualifying disability with generally low-cost healthcare coverage. How much you ultimately pay for healthcare under Medicare varies depending on the Social Security taxes you’ve paid in the past.

The Difference Between SSI and SSDI Benefits

It’s also important to note the difference between Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI). Some people may receive benefits from one program or the other, while other recipients may qualify for payments from both.

SSI is a program designed to assist those who are over the age of 65, blind, or otherwise disabled and who also have limited income or financial resources. SSI recipients do not need to have a certain number of work credits to obtain benefits. As of April 2020, the average monthly benefit for SSI is $576.47. 

SSDI benefits provide assistance to those with a qualifying disability who have also amassed a sufficient number of work credits. As of April 2020, the average benefits for SSDI is $1,121.75 per month.

If You’re On Medicaid and Qualify for SSI

If you are already on Medicaid in your state and you qualify for SSI, you will remain eligible for Medicaid as long as you continue to meet the state-specific requirements for Medicaid. Your SSI benefits will not be included as income when determining eligibility for Medicaid. However, if you receive SSI only, Medicare benefits will not be available to you until you reach the age of 65.

If You’re On Medicaid and Qualify for SSDI

If you are already on Medicaid in your state and you qualify for SSDI (but you do not also qualify for SSI), you will automatically qualify for Medicare after a 24-month waiting period. This waiting period begins five months after the date your qualifying disability began. These additional five months account for the required waiting period before you are eligible to receive disability in the first place.

Thus, if the onset of your disability was more than two years before you were approved for SSDI benefits, you may be able to begin receiving Medicare benefits sooner. Keep in mind that the Social Security Administration only allows retroactive disability payments up to twelve months, meaning your disability onset date may only be recognized as late as 17 months before the day you applied for benefits (taking into account the five-month waiting period). 

As such, your actual waiting period for Medicare could be as little as one year, as opposed to two years and five months. Medicaid may be available in the meantime for those awaiting Medicare coverage.

If You’re On Medicaid and Qualify for SSI and SSDI

If you are already on Medicaid in your state and you qualify for both SSI and SSDI benefits, there is no hard and fast rule on whether you’ll qualify for Medicaid or Medicare. In some cases, it may be possible to receive Medicaid and Medicare benefits simultaneously. Remember that when it comes to Medicaid, although SSI does not count as income, SSDI does.

Need Help Applying for Disability Benefits?

Applying for disability benefits can be a long, confusing, and frustrating process. Waiting periods and application denials are an unfortunately common occurrence. At Social Security Disability Advocates USA, we have the skill and the experience needed to successfully secure disability benefits in the easiest, quickest manner possible. 

If you have questions about Medicaid and disability, contact us today for a free no-obligation consultation. We’ll review your case to give you the best picture of all your legal options. Call us at 602-952-3200. You can also get in touch with us using our LiveChat feature or by sending us the details of your claim through our contact form.

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This is attorney advertising. SSDA, LLC is a group of attorneys that pursues claims for Social Security Disability benefits on behalf of its clients against the Social Security Administration. SSDA, LLC is in no way a part of the Social Security Administration. Further, the information on this blog is for general information purposes only. Nothing herein should be taken as legal advice. This information is not intended to create, and receipt or viewing does not constitute, a representative-client relationship.