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.
Does Medicare or Medicaid Come with Disability?
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.
Original Medicare (Part A and B) Eligibility and Enrollment
To be eligible for premium-free Part A, an individual must be entitled to receive Medicare based on their own earnings or those of a spouse, parent, or child. To receive premium-free Part A, the worker must have a specified number of quarters of coverage (QCs) and file an application for Social Security or Railroad Retirement Board (RRB) benefits. The exact number of QCs required is dependent on whether the person is filing for Part A on the basis of age, disability, or End Stage Renal Disease (ESRD). QCs are earned through payment of payroll taxes under the Federal Insurance Contributions Act (FICA) during the person’s working years. Most individuals pay the full FICA tax so the QCs they earn can be used to meet the requirements for both monthly Social Security benefits and premium-free Part A.
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 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.