March 16, 2018
If you are one of the millions of Americans who receives Social Security Disability Income (SSDI), you may have questions regarding your current and/or potential healthcare benefits. Here, the disability advocates at Disability Associates answer common questions and break down a few of your options.
Do My Current Benefits Impact My Qualification For SSDI?
Your current health insurance has no effect on your eligibility for Social Security Disability Income. Regardless of your current coverage, you are still able to apply for either Medicaid or Medicare. However, it is important to know that—while you may keep your benefits—your current insurance will either remain your primary insurance or drop below Medicaid/Medicare and become your secondary insurance.
The main difference between primary and secondary insurance is that primary insurance will always pay first when it comes to medical expenses, including hospital visits, check-ups and prescriptions. Secondary insurance then steps in as a supplement to primary insurance to pay some, or all, of the remainder. If your employer qualifies as primary insurance, it is typically in your best interest to keep those benefits as your primary and let Social Security cover the remainder. This can also help save money by not having to pay premiums for full enrollment in Medicaid or Medicare.
How Does Medicare Effect Social Security Disability Income?
Those who are approved for SSDI are automatically eligible for Medicare. However, there is a 24-month waiting period before health coverage starts. Once officially enrolled in Medicare benefits, you are considered covered under the health care law and do not have to pay the penalty that one pays for not having health insurance.
If you have been approved for Medicare but are in the 24-month waiting period, you may be able to get Medicaid coverage while you wait. You can apply for Medicaid directly with your state Medicaid agency by visiting the State Resources page on the official Medicaid website. If turned down for Medicaid, you may be able to enroll in a private health plan while waiting for your Medicare coverage to start, and—based on your income and household size—you may qualify for lower costs.
What if I Don’t Qualify for Disability Benefits?
If you are disabled and need health coverage, but did not qualify for Social Security Disability benefits for one reason or another, you will need to weigh your options through the Health Insurance Marketplace. Once you have created an account, fill out an application to find out if you qualify for a private health plan with premium tax credits and other savings based on your income. Here, you will also find out if you qualify for Medicaid coverage.
During this process, you will likely be asked if your disability limits your ability to work, attend school or take care of your daily needs, or if you currently receive daily assistance for your disability. If you answer yes to one or more of these questions, your Marketplace application will be sent to your state’s Medicaid office to see if you qualify for Medicaid based on a disability. If you still do not qualify for Medicaid based on your disability, you may still qualify based on income alone. You can find out if you qualify for Medicaid based on income level by visiting the government’s resource for saving money on health insurance based on income level and savings.
The Disability Advocates at Disability Associates are Here to Help
The many nuances of healthcare and Social Security are often overwhelming. For the attorneys at Disability Associates, our sole mission is to advocate for those with—or in need of—Social Security, to ensure they receive the benefits they deserve. Get in touch with us today for more information on how we can be of service.