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.
Benefits for People with Disabilities
The Social Security and Supplemental Security Income disability programs are the largest of several Federal programs that provide assistance to people with disabilities. While these two programs are different in many ways, both are administered by the Social Security Administration and only individuals who have a disability and meet medical criteria may qualify for benefits under either program.
Medicare Eligibility Rules
If you are age 65 and currently receiving Social Security or Railroad Retirement Benefits, you are eligible for Medicare and you will be automatically enrolled in Medicare Part A and Part B. However, because Part B has a premium, you have the option of declining Part B coverage. In addition, Part B does require payment of a monthly premium of $104.90, barring certain exceptions, for individuals enrolling in Part B January 1, 2015 or later. These premiums can change on an annual basis.
Medicare Disability Coverage For Those Under 65
Commenting in an essay The Long Wait: The Impact of Delaying Medicare Coverage for People with Disabilities, Stuart Guterman of the Commonwealth Fund stated that, At a particularly difficult point in their lives, disabled individuals must wait two years before they are eligible to begin receiving Medicare benefits—a delay that can block access to needed care and relief from financial pressures.
Medicare and Social Security Disability Benefits
You can get financial help from Social Security and Medicare if you’re permanently disabled or if you have Lou Gehrig’s disease or kidney failure. To be considered “permanently disabled,” your doctor must confirm that you are unable to work for at least 12 consecutive months. Being “unable to work” means you cannot perform your job functions because of the disability, and you cannot find a new line of work because of age, education, or impairment. You must follow your doctor’s prescribed treatment plan to continue to qualify. It’s a good idea to keep up-to-date medical records.
Individuals with Disabilities
Many individuals who qualify for Medicaid based on disability also receive cash assistance under the Supplemental Security Income (SSI) program. In almost all states, SSI eligibility automatically qualifies an individual for Medicaid coverage. However, some states use more restrictive eligibility criteria than those used by the SSI program. This means that in those states (commonly referred to as 209(b) states) receipt of SSI does not guarantee eligibility for Medicaid. Individuals not receiving SSI but seeking coverage based on disability must demonstrate that they have an impairment that prevents them from performing "substantial gainful activity" for at least one year. Once a disability determination is made, the individual must then undergo an asset test and meet specific income requirements in order to be considered for Medicaid eligibility.
Medicare Coverage if You’re Disabled
If you have amyotrophic lateral sclerosis (ALS or Lou Gehrig’s disease), you will automatically be enrolled in Medicare Part A (hospital insurance) in the first month that you begin receiving Social Security disability benefits. You will automatically be enrolled in Medicare Part B (medical insurance) if you live within the 50 United States or District of Columbia. You will have the option to refuse the automatic enrollment in Medicare Part B if you already have medical insurance. If you need prescription drug insurance, you will have to enroll in a Medicare Part D prescription drug plan separately.
SSI & Medicare Eligibility
Those on SSI insurance should receive a package in the mail three months before they are officially eligible for Medicare. This package will contain information about their Medicare benefits, along with the red-white-and-blue Medicare benefits card. Those who are on SSI before they become eligible for Medicare are automatically enrolled in Part A and Part B. Their Part B premiums are deducted from their SSI check. If they do not want Part B, they must actively opt out. The directions for doing this are included in the packet that is sent out before they are eligible that includes their Medicare card. If they do not want their Part B premium deducted from their check, they must contact Social Security and request to be billed for it instead.
Medicare Eligibility Requirements
In purchasing a Medigap Supplemental Insurance Policy, getting enrolled by the initial enrollment period is very crucial. If you apply during the IEP, by law, you are guaranteed that all insurers selling Medigap coverage in your state must offer you all the Medigap Supplemental Policy coverage plans that they sell. In addition, this guarantees, by law, that the insurance rate premiums offered to you will be the same as a person considered to be in good health. This applies, regardless of the fact that your current or past health history may not have been good or you have ongoing health issues.
How Long Does It take to Get Medicare Coverage Through Social Security Disability (SSD)?
However, your onset date for payment purposes can only be 17 months before your application date — that’s because Social Security allows a maximum of 12 months of retroactive benefits. (This maximum gets you to 12 months before your application date, plus five months for the waiting period, so your earliest established onset date is 17 months before the application date.) In turn, the earliest you can become eligible for Medicare is two years after you apply for Social Security disability. (For more information on calculating your date of entitlement, our article on disability onset and backpay.)
Medicare Benefits for Disabled
Enrollment in Medicare is automatic if you have already been receiving Social Security disability benefits at the time you become eligible for Medicare. Enrollment in Medicare Part A is compulsory, but you can decline to enroll in Medicare Part B by filling out a form that will be sent to you, and you will not have to pay the premium for Medicare Part B. If you change your mind, you can still enroll later during a special open enrollment period. Your enrollment in Medicare Part A, however, will not cost you anything, and since Medicare Part A will be the secondary payer to your group health insurance plan anyway, think twice before declining coverage.
Medicare Eligibility Requirements
If you’re turning 65, you have an opportunity to enroll in Medicare. You can enroll three months before the month you turn 65, the month of your birthday or three months after your birth month. Eligibility requirements include:
SSDI Eligibility Requirements
To be eligible for Social Security Disability Insurance, the first and most important requirement is that you must have paid into Social Security at some point in your life. Another way to satisfy this requirement is to be the spouse or dependent of someone who has. The way that the Social Security Administration determines this is through work credits, of which you receive one per quarter, or four per year. For those without the required amount of work credits, other Social Security programs may be available, such as Supplemental Security Income (SSI).
Medicare Eligibility and Enrollment
re already getting Social Security checks, you will be automatically enrolled in traditional Medicare. You’ll get your Medicare card three months before your 65th birthday. The benefits kick in on the first day of the month of your 65th birthday. Traditional Medicare, which is also called original Medicare, includes Medicare Parts A and B. Part A is hospital coverage. Part B covers doctor visits, lab tests, and other outpatient services.