Do You Get Medicare Or Medicaid From Social Security Disability in Texas?

Generally speaking, any individual in Texas who is entitled to A) receive Supplemental Security Income (SSI) or B) receive both Social Security Disability and SSI disability (concurrent benefits) will be entitled to Medicaid at the month of their entitlement to disability.

In the case of beneficiaries receiving SSI disability only, the date of filing is generally the date of disability entitlement, thus the entitlement date for Medicaid.

Two things to point regarding medicaid.

1) Medicaid is a need based medical insurance program; consequently any individual who receives Medicaid must meet income and resource (asset) limits.

2) If a Social Security Disability beneficiary has a low benefit amount, they may still be able to qualify for Medicaid, even if their disability benefit is too high to be concurrently entitled to SSI.

Medicare, like Social Security Disability, is based upon an individual's insured status, not simply income and resources. If an individual is approved for Social Security Disability benefits, they will not be eligible to receive Medicare insurance benefits for two years following the first month they became eligible to receive their disability benefits.

Another way of putting it is that an SSD beneficiary in Texas will have coverage for medicare after A) the five month waiting period has been served (this five month period applies only to Social Security Disability, not SSI) and B) after the 2 year or 24 month waiting period for medicare has been served.

Some claimants who have been approved for Social Security Disability will have a gap time period in which they have no coverage under medicare, due to these waiting periods. However, because many Social Security Disability claims literally take years to finish (from the disability application to the reconsideration appeal, to the disability hearing, etc), many claimants will have already served these waiting periods by the time they finally receive notification that their disability claim has been approved.

Things to remember regarding medicare:

1) Once an individual is entitled to Medicare part A and B benefits, they are eligible to enroll in part C and D.

2) Medicare offers part C and D premium programs to help with prescriptions and medical expenses that are nor covered by parts A and B.

3) Medicare parts C and D are not free, so there is an additional monthly premium involved.

4) Medicare does offer help with the additional premium cost if an individual meets the income and resource limit for the Medicare part C and D subsidy program.

In conclusion, if you are approved for Social Security Disability only with no ongoing SSI disability entitlement and you have health insurance, do not give up your coverage if possible. You will not be eligible for any Medicare for two years after your date of entitlement to Social Security benefits.

Additionally, check with your local Social Services office to see if you might be entitled to Medicaid even if your Social Security benefit is a little too high for SSI benefits.

About the Author: Tim Moore is a former Social Security Disability Examiner in North Carolina, has been interviewed by the NY Times and the LA Times on the disability system, and is an Accredited Disability Representative (ADR) in North Carolina. For assistance on a disability application or Appeal in NC, click here.

Most popular topics on

Social Security Disability in North Carolina

Common Mistakes to avoid after being denied for Disability

Tips to Prepare for Filing for Social Security Disability or SSI

Advice to Win SSD and SSI Benefit Claims

Social Security Disability SSI Questions

What is the difference between Social Security Disability and SSI?

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?

Social Security Disability SSI Exam tips

More Social Security Disability SSI Questions

What makes you eligible for Social Security Disability or SSI?

Related pages:

Is it difficult to get an approval for SSI Disability in Texas?
How often will my disability claim be reviewed in Texas?
Do You Get Medicare Or Medicaid From Social Security Disability in Texas?
Does Social Security Disability have a Time Limit for Receiving Benefits in Texas?
If you are on Social Security Disability or SSI disability in Texas should you try to work?
If You get Disability Benefits in Texas, will Your Dependents get a Check?
What if you get Disability Benefits in Texas and move to another state?
If My Doctor Gives Me a Letter Will I Get Disability in Texas?
If I Get Social Security Disability in Texas Will They Cut Off My Benefits Later?
Can I Get Disability in Texas if I Have Not Worked Before?
If your Texas disability claim is turned down, you can file an appeal with social security
Who is eligible for Social Security Disability or SSI Disability in Texas?

These pages provide answers to basic questions about pursuing disability benefits

What to Prove to Qualify for Disability Benefits
Applying for disability benefits, SSI and SSDI
What Disabilities Qualify for SSI and Social Security Disability?
How does back pay for Social Security Disability work?
Social Security Disability And SSI Qualifications
Permanent Disability Qualifications for SSD and SSI
Status of your Social Security Disability or SSI case
Disability lawyer representation, finding lawyers
What is qualifying for disability based on?
How to qualify for disability, qualifying for Benefits
Qualifications for Disability Benefits
How long does it take to get disability after applying?
Disability application, how to file in Texas
Texas disability requirements
Eligibility and qualifying for disability in Texas
What are the qualifications for disability in Texas?
Will I Qualify For Disability Benefits in Texas?
Getting a Texas disability lawyer, attorney, or advocate