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Understanding Medicare and Medicaid for Social Security Disability


If you qualify and are approved for one of the Social Security Administration (SSA) disability benefits programs, you may be aware that you could also qualify for medical coverage under Medicare, Medicaid – or even both. The benefits of these programs are significant for someone with a disability, since the costs of treatment and ongoing care can be significant. Generally, if you’re approved for Social Security Disability Insurance (SSDI), you receive Medicare; those who qualify for Supplemental Security Income (SSI) receive Medicaid.

Still, the specifics are more complicated. There’s a lot of confusion about eligibility, when the perks kick in, and what you need to do to obtain them. As a result, setting up a consultation with a Maryland Social Security disability attorney is a must. Some basic information might also be helpful. 

Medicare for SSDI Recipients: SSDI is an insurance program in which you can receive benefits if you:

  1. Suffer from a qualifying medical condition that renders you unable to work and is expected to last longer than one year; and,
  2. Accumulated sufficient work credits over your career, which is important because you pay into Social Security as a sort of insurance premium while you’re employed.

If you’re approved for SSDI benefits, you’ll receive benefits starting six months after SSA determines that your disability began. This date is known as your date of entitlement. From there, you have a 24-month waiting period for Medicare coverage. When you become eligible, you will automatically be enrolled in Medicare Part A for hospital costs. You may opt in for Part B, but you may have to pay for coverage. 

Medicaid and Medicare SSI Recipients: SSI is a needs-based program for purposes of disability; likewise, eligibility for Medicaid is also primarily determined by your income and assets. Therefore, you automatically qualify for Medicaid if you receive SSI benefits and there’s nothing further you need to do. Plus, there’s no waiting period for Medicaid as there is with Medicare for SSDI. Your Medicaid benefits include:

  • Hospital services;
  • Services from a physician and specialists;
  • Lab screenings and x-rays;
  • Home health care;
  • Clinic services;
  • Care for diabetes;
  • Physical therapy;
  • Eye glasses, if you’re under 21 years old;
  • Prescription medications; and,
  • Much more.

It’s possible that you may qualify for both Medicaid and Medicare as a recipient of SSI benefits, a situation known as “dual enrollment.” The key is whether you receive partial or full Medicaid benefits, as well as other qualification factors. If you’re eligible for dual enrollment, you probably won’t have to pay anything out-of-pocket for most health care costs, services, and medications. 

Our Maryland Social Security Disability Lawyers Can Provide Details 

If you’d like more information about receiving Medicare and Medicaid benefits under Social Security disability programs, please contact the Law Offices of Steinhardt, Siskind and Lieberman, LLC. We can schedule a free consultation to review your circumstances, explain the specifics, and assist with the process. Our Maryland Social Security disability attorneys represent clients throughout Maryland from our offices, and we can help you, too.

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