How to file for disability, Filing for SSI
Disability Requirements, Disability Status
How long is the wait?, Disability Application
The Social Security List of Impairments
Qualifying for Disability, Mental Disability
Disability Lawyer Info, Disability Back Pay

Social Security Disability Medicare Health Coverage

Social Security Disability beneficiaries will not in some cases receive Medicare insurance coverage immediately upon being approved for disability benefits. Unfortunately, Social Security Disability beneficiaries have a two year waiting period for Medicare disability health coverage that begins with the first month they are eligible for monthly disability benefits.

Not only is there a wait of two years for health coverage, the waiting period does not begin with the month they became disabled but the month they are eligible to receive a monetary benefit. For some Social Security Disability beneficiaries the additional five month Social Security waiting period just prolongs the wait for health coverage.

However, there are some mitigating factors that can can often ease the effect of the twenty-four month Medicare waiting period.

When do you not have to actually wait two years for medicare health coverage?

If a beneficiary is approved at an administrative law judge disability hearing their date of entitlement is usually determined to be in the past. This is because, by the time a decision at a disability hearing has been made, 2-3 years have often passed from the time an application for disability was initially filed.

Thus, many beneficiaries have already waited more than twenty-four months to get to their hearing. As a result, their twenty-four month Medicare waiting period has already passed when they are approved for disability and they begin to receive medicare immediately.

Even if a beneficiary is approved at the initial disability claim level. or reconsideration appeal level, they may still have served a good portion of the twenty-four month Medicare waiting period. This is because Social Security Disability beneficiaries are allowed twelve months retroactive entitlement if they have not worked for at least seventeen months prior to filing for disability.

With an entitlement date twelve months in the past, disability applicants serve a good portion of their Medicare insurance waiting period by the time they are approved for disability. The twenty-four month Medicare waiting period most adversely affects disabled individuals who are approved for disability at the initial disability claim level and have worked up to the date they filed for disability benefits—meaning that, in those cases, there has not been an extended period of time between applying for disability and actually getting disability benefits.

What are the Medicare entitlements and what do they cover?

The Medicare insurance program offers two major health coverage entitlements: Medicare part A and B, along with more recent additions part C and D. Medicare Part A is free coverage that covers some of the expenses incurred during a hospitalization, while Medicare Part B is meant to cover doctor visits both in and out of the hospital as well as some types of testing.

Medicare Parts C and D were put in place to help with prescriptions and to provide a way for Medicare recipients to pay expenses not paid by Medicare part B. It is important to remember Medicare is a twenty / eighty insurance policy at best; this means that Medicare beneficiaries may left owing twenty percent of their bill if they only have Medicare Part A and B.

Medicare Part B, C, and D have premiums that can be deducted from a disability beneficiary’s monthly disability benefits.

Social Security works with many insurance companies to help provide more cost effective coverage for disability beneficiaries. Some disabled individuals may qualify for a subsidy that offsets the cost of their Medicare part C and D. Others may be eligible for help paying their part B Medicare premiums through their local Social Service offices.

Health coverage for individuals receiving SSI Disability

Those who receive SSI only do not receive medicare. Supplemental Security Income disability (SSI) beneficiaries are entitled to receive Medicaid health coverage immediately. They have no waiting period for health benefits. Medicaid for disabled adults generally (we say generally because Medicaid eligibility and coverage can differ from state to state) provides for hospitalizations, some testing, a minimum number of doctor's visits per year, and a minimum number of medication prescriptions per month.

While most Social Security Disability beneficiaries are not eligible for Medicaid for the entire two year waiting period for Medicare health coverage, they may be entitled to receive Medicaid for the five month waiting period (that applies to Social Security Disability) or even longer if they are concurrently entitled to receive both Social Security Disability and SSI disability benefits.

Some Social Security Disability beneficiaries have monthly disability benefits that are lower than the SSI maximum monthly disability benefit amount; making them potentially eligible for monthly SSI disability benefits provided they meet income and resource requirements.

Essential Questions

What is the Social Security Disability SSI list of impairments?

Can you work while getting or applying for Disability?

How Often Does Social Security Approve Disability The First Time You Apply?

Tips for getting Social Security Disability or SSI benefits approved

What medical conditions will get you approved for disability?

What kind of Mental Problems Qualify for Disability?

Receiving a Disability Award Letter

Conditions Social Security will recognize as a disability

Previously answered questions regarding SSD and SSI

Applying for disability in your state

Most popular topics on SSDRC.com

Social Security Disability SSI Questions

The listings, list of disabling impairments

Can a mental illness qualify you for disability?

Disability Lawyers prevent unnecessary denials

How much Social Security Disability SSI back pay?

How to apply for disability for a child or children

Filing a Social Security Disability SSI application

Filing for disability - when to file

How to apply for disability - where to apply

Qualifications for disability benefits

How to Prove you are disabled and Win your Disability Benefits

Qualifying for Disability - The Process

How to get disability for depression

Getting disability for fibromyalgia

SSI disability for children with ADHD

What is the Application Process for Social Security Disability and SSI?

Common Mistakes to avoid after being denied for Disability

Social Security Disability SSI Exam tips

More Social Security Disability SSI Questions

Social Security Disability SSI definitions

What makes you eligible for Social Security Disability or SSI?

New and featured pages on SSDRC.com

Who can help me file for disability?

Related pages:

If You Get Approved For SSDI Will You Also Get Medicare?
If you are applying for Social Security Disability when does Medicare start?
Do I automatically receive Medicare benefits if I'm approved for disability benefits? (not SSI)
Social Security Disability Health Coverage
Do you get medical healthcare benefits with Social Security Disability?
The Social Security Medicare 24 Month Waiting Period
How do you get meds in the two wait for Medicare after an Approval for Disability?
Does Social Security Disability pay for medicine prescriptions?
Why doesn't Social Security Disability provide automatic medical care when SSI does?
Do you get medical health care coverage with SSI?
Eligibility for disability with ADHD
If you apply for disability in New Mexico
Getting a Disability Lawyer in New Mexico

These pages answer some of the most basic questions for individuals who are considering filing a claim.

Can you get temporary Social Security Disability or SSI benefits?

Permanent Social Security Disability

What is the difference between Social Security Disability and SSI?

Who is eligible for SSI disability?

Can I Be Eligible For SSI And Social Security Disability At The Same Time?

What makes a person eligible to receive disability benefits?

Applying for Disability - How long does it take to get Social Security Disability or SSI benefits?

What happens if I file a disability application and it is denied by a disability examiner or Judge?

For the sake of clarity, SSDRC.com is not the Social Security Administration, nor is it associated or affiliated with SSA. This site is a personal, private website that is published, edited, and maintained by former caseworker and former disability claims examiner, Tim Moore, who was interviewed by the New York Times on the topic of Social Security Disability and SSI benefits in an article entitled "The Disability Mess" and also by the Los Angeles Times on the subject of political attempts to weaken the Social Security Disability system.

The goal of the site is to provide information about how Social Security Disability and SSI work, the idea being that qualified information may help claimants pursue their claims and appeals, potentially avoiding time-consuming mistakes. If you find the information on this site helpful and believe it would be helpful to others, feel free to share links to its homepage or other pages on website resource pages, blogs, or social media. Copying of this material, however, is prohibited.

To learn more about the author, please visit the SSDRC.com homepage and view the "about this site" link near the bottom of the page.