What is the Application Process for Social Security Disability and SSI?
How do you Win Benefits under Social Security Disability or SSI?
If I am determined disabled, how far back will Social Security pay benefits?
How do you prove your disability case if you have a mental condition?
What Can I Do to Improve My Chances of Winning Disability Benefits
Common Mistakes after Receiving a Denial of Social Security Disability or SSI Benefits
How to File for Disability - Tips for Filing
If You Get Approved For SSDI Will You Also Get Medicare?
How much does a Social Security disability attorney get paid?
Social Security Disability SSI Criteria and the Evaluation Process
How long does it take to be approved for SSI or Social Security disability?
What do you Need to Prove to Qualify for Disability Benefits?
Social Security Disability SSI and Fibromyalgia
Social Security Disability SSI and Degenerative Disc Disease
Can I Qualify For Disability and Receive Benefits based on Depression?
Answers to questions about SSD and SSI disability
What Disabilities Qualify for SSI and Social Security Disability Benefits?
Social Security Disability Status
Social Security Disability Tips — how a claim gets worked on
Social Security Disability, SSI Disability - Terms, Definitions, Concepts
Do you get medical healthcare benefits with Social Security disability ?
How to prove you are disabled
and win disability benefits
Social Security offers healthcare benefits through the Medicare health insurance program. Medicare is available to individuals age 65 and older, disability beneficiaries, and individuals with end state renal disease that requires dialysis or a kidney transplant.
The different parts of Medicare
Medicare insurance consists of two major parts. Part A is hospital insurance and Part B is medical insurance. Medicare Part A is free to an eligible beneficiary; however Part B is paid for through monthly premium deductions or payments.
Medicare also offers two other programs used in conjunction with Part A and B. Medicare part C (also known as Medicare Advantage) plans allow an individual to choose to have all their health care services through an insurance provider. Medicare part C plans help some beneficiaries lower their medical costs and for a monthly fee they may get some additional benefits.
Lastly, Medicare offers a Part D to help with prescription drug coverage. Part D coverage is voluntary and it is paid for by monthly premiums. If an individual meets certain means testing (eligibility ) requirements, they may be eligible for a subsidy that helps offset the cost of Part D coverage. Additionally, some disability and retirement beneficiaries may be eligible for help in paying their Medicare part B premiums provided that they meet income limits.
The Medicare Waiting Period
Unfortunately, Social Security disability beneficiaries have a Medicare waiting period that in most cases must be served before they are eligible for healthcare coverage. Medicare has a twenty-four month qualifying period, or waiting period, for health coverage. The twenty-four month period begins with the first month that an individual is eligible to receive a monthly monetary disability benefit.
For example, if an individual is entitled to receive Social Security disability benefits starting in March of 2018, they will not be entitled to Medicare healthcare coverage until March 2020. While this seems like a long time, many Social Security disability beneficiaries do not notice the wait so much, because they were approved for disability benefits at an administrative law judge disability hearing. Due to the long wait for disability hearings and the decisions following them, many have either served a good portion or even the entire Medicare qualifying period by the time that they are approved for disability benefits.
Even if an individual is approved at their initial disability claim, they may have served twelve months of their waiting period. Social Security allows a twelve month retroactive disability benefit period that begins with the date of filing. If a disability beneficiary was unable to work for seventeen months prior to filing for disability, they may be entitled to the entire twelve month period of retroactive benefits. This means they have already served a year of the Medicare qualifying period. Still other individuals may have their Medicare qualifying period lessened if they have had other periods of disability entitlement, or, in some cases, SSI disability entitlement.
Special rules apply to:
1. Social Security beneficiaries who receive their Medicare benefits on the basis of end stage renal disease requiring a course of dialysis. They are entitled to Medicare insurance benefits the first day of the third month following the month they began dialysis. For example, if an individual began their dialysis on May 15, 2018 they would be entitled to Medicare benefits as of 8/01/2018.
2. Individuals who have kidney transplants are entitled to Medicare benefits the month they receive their kidney transplant.
3. Individuals who have Lou Gehrig’s disease (amyotrophic sclerosis) get their Medicare benefits the first month they are entitled to receive their disability benefits.
Still other Social Security disability beneficiaries may be eligible for healthcare benefits through the Medicaid health coverage program during their twenty four-month waiting period provided they meet the income and resource limits of the Medicaid program. This is true especially true for disability beneficiaries who are entitled to SSI disability or who are entitled to both SSI and Social Security disability.
Individual states set the rules and guidelines for their Medicaid programs, consequently coverage may differ from state to state.
Individual Questions and Answers
SSD and SSI are Federal Programs
The title II Social Security Disability and title 16 SSI Disability programs operate under federal guidelines and, therefore, the program requirements--medical and non-medical--apply to all states:
Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Florida, Georgia, Hawaii, Idaho, Indiana, Illinois, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, Wyoming
Recent approval and denial statistics for various states can be viewed here:
Social Security Disability, SSI Approval and Denial Statistics by state
Special Section: Disability Lawyers and unnecessary claim denials