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

Do I automatically receive Medicare benefits if I'm approved for disability benefits?

You will not receive medicare benefits if you are approved for title 16 disability benefits. Title 16 is another way of saying SSI, or supplemental security income, disability. SSI recipients receive medicaid benefits and these benefits may vary from state to state. Typically medicaid will provide for a specified number of physician visits per year, as well as a specified number of medication prescriptions per month.

If you are approved for title 2 disability benefits (Social Security Disability insurance, or SSDI), then you will receive medicare. However, there are some unfortunate restrictions that concern just when a person who is eligible to receive SSDI benefits may access their medicare coverage.

It is commonly reported that a person has to wait for 24 months before they can use their medicare coverage. However, saying it this way is a bit misleading. It is more accurate to say that in the SSA (the social security administration) disability system, medicare begins 24 months from the month that a beneficiary became entitled to receive their SSDI monthly benefits.

What does this mean exactly? Simply this: if a person files an application for disability, they claim something known as an AOD, or alleged onset of disability. This is the date that they presume that they became disabled.

Do their disability benefits begin from this date? Not exactly. Depending on the level the claim is currently at--it depends on the judge (administrative law judge) or the disability examiner determining when the claimant's condition became disabling. This is done according to the social security administration definition of disability. This determination is based on a review of the claimant's work history and medical treatment history and the analysis provides for something known as an EOD, or established onset of disability.

So, back to the crux of the matter, when does medicare start? Basically---

1. You start with the EOD, the date given for when the claimant's disability is thought to have begun, based primarily on the medical records.

2. Add five months to this date. Why five months? This is known as the five month waiting period. This 5 month waiting period only applies to SSDI, not SSI, and it essentially takes away five months of benefit payments to anyone who is approved for SSDI benefits. Why does it exist? Possibly because of the supposition that some claimants may already have long term disability insurance coverage. However, the simple truth, when it all comes out in the wash, is that this is simply a cost-savings device for the federal government.

3. The established date of onset (EOD), plus the five month waiting period, gets you to a date that is considered the month of entitlement. This is actually the first month in which an SSDI applicant is eligible to receive monthly disability benefits. If a claimant's established date of onset is set far enough back to allow for back pay (months for which the social security administration owes claimants money), then this is the time from which back pay would be calculated.

4. Twenty-four months after the month of entitlement is when medicare coverage begins.

If this sounds like a very long wait...it can be. However, because a disability case can literally drag on for years before a person is eventually approved for disability benefits, a few things often happen.

1. The claimant is usually owed back pay. Often significant amounts of back pay.

2. Very often, the five month waiting period has already been served out so that the approved individual can immediately begin receiving disability benefits.

3. Often as well, the 24 month waiting period will have been served out as well, meaning that access to medicare can be obtained quickly after the case has been concluded.

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?
Social Security Disability and Bilateral Hearing Loss
Getting disability approved in Florida
Getting a Disability Lawyer in Florida
Qualifying for SSDI in Florida

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

How to file a disability application
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.