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.
Disability Planner: Medicare Coverage If You’re Disabled
Everyone with Medicare also has access to prescription drug coverage (Part D) that helps pay for medications doctors prescribe for treatment. For more information on the enrollment periods for Part D, we recommend you read Medicare’s "How to get drug coverage" page.
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.
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 your effective onset date can be is 17 months before the application date.) In this case, the earliest that you can become eligible for Medicare is one year after you apply for Social Security disability. But for disability applicants who apply for benefits only when they become disabled, and not before, the date that their Medicare coverage will start is more likely to be two years and five months after they apply for disability.
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.