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What Insurance Do You Get With Social Security Disability?

— June 21, 2022

If your Medicare coverage begins and your income and resources continue to make you eligible for SSI along with SSI, you may qualify to have your Medicare Part B premium paid for you.

Monthly Social Security disability payments can make a difference in the life of people who are disabled or blind by providing a much-needed source of income. For someone with limited income and resources, Supplemental Security Income benefits may be their only means of providing for food and shelter.

It is easy to overlook another important benefit available when you qualify for SSD benefits through SSI and, for those individuals who paid into the Social Security system through jobs or self-employment, Social Security Disability Insurance. If you qualify for SSI or SSDI, medical insurance coverage may be available through either Medicaid or Medicare. 

The insurance coverages are different, so the information that follows offers an overview of each of them. Keep in mind that additional information about benefits is available by contacting Disability Law. They also can provide you with an experienced SSD lawyer to represent you in filing an application for benefits and appealing a denial or termination of benefits. 

What Insurance Do You Get With SSI?

SSI eligibility is based on need. You must have limited income, and the resources or assets that you have available to use to pay for food or shelter cannot exceed $2,000 for an individual or $3,000 for married couples when both spouses qualify for benefits. The program is available to people meeting one of the following criteria:

  • Disabled
  • Blind
  • Elderly, which the Social Security Administration defines as 65 years of age or older.

Income generally cannot exceed $841 for an individual and $1,261 for married couples where both spouses are eligible for benefits. Talk to an SSI lawyer at Disability Law because there may be exclusions allowable under federal Social Security regulations to reduce the amount of income that counts against your SSI benefit.

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If you qualify for SSI, you may be eligible for Medicaid coverage. Medicaid pays the cost of medical care for children and adults approved for SSI. States administer the Medicaid program using guidelines established under federal law. States also have the ability to set stricter eligibility standards than those set by federal law.

Approval for federal SSI benefits makes you automatically eligible for immediate Medicaid coverage in most states, including Indiana. States that require a separate application for Medicaid coverage automatically grant Medicaid to SSI beneficiaries, but a few states, such as Connecticut and Virginia, do not. These states use eligibility guidelines that are more restrictive, so being approved for federal SSI benefits does not automatically result in Medicaid approval.

Some states extend Medicaid coverage to the children of SSI beneficiaries. Check with an SSD lawyer at Disability to learn more about Medicaid coverage in your state. 

Medicare Insurance and SSDI Beneficiaries

If you have a work history and paid into the Social Security through payroll taxes or self-employment taxes, you may be eligible for SSDI benefits. Insurance coverage through the Medicare program, which generally is not available until someone reaches 65 years of age.

You do not qualify for Medicare until you receive SSDI benefits for 24 months unless you suffer from permanent kidney failure and require dialysis or a transplant. The waiting period also does not apply to someone diagnosed with amyotrophic lateral sclerosis (ALS), which is commonly referred to as Lou Gehrig’s disease.

If you qualify for Medicare while receiving SSDI, you receive Part A coverage that is also referred to as Medicare Hospital Insurance. It pays for medical treatment at a hospital. There is no cost to you for Medicare Part A insurance.

Once eligible for Medicare, you may elect to enroll in Medicare Part B coverage, which is also referred to Supplementary Medical Insurance. It pays for outpatient care that you receive outside of a hospital setting, including office visits with physicians and other medical providers. There is a premium that you must pay each month to receive Medicare Part B coverage.

If you have difficulty paying for medical care during the 24-month waiting period for Medicare coverage, a Disability SSDI lawyer may have an option available for you. Depending upon your financial circumstances, including the amount of your monthly SSDI benefits, and the Medicaid eligibility guidelines in your state, you may qualify for Medicaid at least until you become eligible for Medicare.

What Insurance Do You Get When You Qualify For SSI And SSDI?

Some people may qualify for payments through both the SSI and SSDI programs, which makes them eligible for Medicare and Medicaid. If that applies to you, Medicaid would be your primary medical insurance for the first 24 months that you receive SSDI. It becomes the secondary insurer when you begin coverage under Medicare.

If your Medicare coverage begins and your income and resources continue to make you eligible for SSI along with SSI, you may qualify to have your Medicare Part B premium paid for you. Most states have programs for SSI beneficiaries that pay the Part B coverage option.

An SSDI and SSI Lawyer Get You The Benefits You Deserve

An SSD lawyer at Disability Law has the knowledge, experience and skills to ensure that you receive all of the SSD benefits you are entitled to under the law. Contact us today for a free consultation.

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