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Medical insurance with disability benefits?

With soaring healthcare costs many disability recipients need medical insurance more than they might need a monthly disability payment. Recently on our disability forum a user asked, “If I receive Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) will I also receive medical insurance?”

SSDI and medical insurance


Assuming you qualify to receive SSDI benefits, which means you are considered disabled, you are insured for SSDI, and you cannot work for at least 12 continuous months, you will also be eligible for medical insurance through Medicare. There is one caveat: you will not receive Medicare until you have been receiving SSDI benefits for 24 months.

After you have received SSDI for two years the SSA will automatically enroll you in Medicare. You will be eligible to receive both hospital insurance and medical insurance. According to the SSA, “Hospital insurance (Part A) helps pay for inpatient hospital bills and subsequent follow-up care.” This benefit will be provided at no extra cost to you.

You will also receive medical insurance (Part B) which will pay a portion of your doctors' bills, outpatient hospital care and other medical services. This coverage is optional, and if you choose this coverage you will have to pay a monthly premium. You will also have access to prescription drug coverage (Part D) which will cover certain medications prescribed for your treatment.

Medical insurance why do I have to wait so long?


According to the SSA, the waiting period was introduced when the SSDI benefits were created as a cost-saving measure. There is no expectation that this requirement will be modified. There are, however, certain claimants who may receive medical insurance through Medicare without waiting. Specifically those with end-stage renal disease (ESRD) with kidney failure who need dialysis or a kidney transplant and claimants with Amyotrophic lateral sclerosis (ALS).

SSI and medical insurance through Medicaid


Claimants who do not qualify for SSDI benefits but who receive Supplemental Security Income benefits will also not receive Medicare. They may, however, receive medical insurance through Medicaid.

In most states, if you are an SSI beneficiary you may be automatically eligible for Medicaid. According to the SSA, “Thirty-two states and the District of Columbia provide Medicaid eligibility to people eligible for Supplemental Security Income (SSI ) benefits. In these States, the SSI application is also the Medicaid application. Medicaid eligibility starts the same months as SSI eligibility.”

State procedures differ, however. In some states the same rules apply for both SSI and Medicaid but you will have to complete a separate Medicaid application (Alaska, Idaho, Kansas, Nebraska, Nevada, Oregon, Utah, and the Northern Mariana Islands).

In other states, however, receiving Supplemental Security Income will not automatically guarantee that you will receive Medicaid. In these States a separate application for Medicaid must be filed: Connecticut, Hawaii, Illinois, Indiana, Minnesota, Missouri, New Hampshire, North Dakota, Ohio, Oklahoma, Virginia.

If you have questions about your medical insurance options contact the SSA for more information.
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