If you are disabled and unable to work as a result of your disability, you may be facing many financial difficulties. It can feel overwhelming and even scary. While struggling with a disability is extremely difficult, the good news is that you do not have to struggle alone.
Millions of people across the country receive monthly benefits from the Social Security Administration in the form of either Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) benefits. Certainly, these programs provide financial benefits in terms of monthly payments. Even better news for recipients is that they also offer health insurance coverage to those who qualify. Without question, health insurance is essential when you have a disabling medical condition.
Let’s take a closer look at the benefits offered and the health insurance options that might be available.
What Types of Benefits Are Available?
Generally, the Social Security Administration offers two types of disability benefits. These include:
- Social Security Disability Insurance (SSDI): SSDI benefits are those offered by the Social Security Administration to individuals who are “insured” and who have a qualifying medical condition that has rendered them disabled for at least one continuous calendar year or more. To the Social Security Administration, being “insured” means that you worked at a job for a sufficient length of time and regularly paid part of your salary as taxes into the Social Security system. Typically, those who receive SSDI benefits will receive payment amounts based on their work and earning history. Generally, the more an individual pays into the system, the higher the benefit amount will be.
- Supplemental Security Income (SSI): As with SSDI benefits, those who receive SSI benefits must have a qualifying medical condition that rendered them disabled for at least one continuous calendar year or more. Unlike the case with SSDI benefits, however, individuals need not be “insured” to receive SSI benefits. Instead, they must have income and resources below a certain threshold established by the Social Security Administration. Depending on various economic factors, that limit may change yearly, so it is essential to consult with an attorney regarding your eligibility in light of your particular circumstances. As with SSDI benefits, SSI benefit amounts are not based on a specific medical condition but instead on an individual’s overall economic situation.
Depending upon your particular situation, you may qualify for one or both types of benefits. The benefit you receive will determine whether you are eligible for Medicare, Medicaid, or both.
Medicare or Medicaid? SSDI and Medicare
SSDI beneficiaries typically qualify for Medicare after receiving disability benefits for at least two years. As a general rule, the federal Medicare program typically serves individuals 65 and older, but exceptions are made for younger adults with a disability. The general reason for the two-year waiting period is economic. When Congress initially voted decades ago to expand Medicare to cover those with disabilities, it included a two-year delay to mitigate the cost of adding those beneficiaries to the Medicare program. In some cases, the waiting period may be waived for people who have certain severely disabling conditions that progress quickly – amyotrophic lateral sclerosis (ALS or Lou Gehrig’s disease) or end-stage renal disease are two examples.
Generally, those who receive Medicare as part of the SSDI benefit program will likely not pay for Medicare Part A (hospitalization coverage) if they paid Medicare taxes while working. However, those individuals will usually have monthly premiums for Part B Medicare coverage, which includes physician and outpatient services, and a Part D prescription drug plan if they choose to enroll in such a program. Generally, these costs are deducted from the individual’s monthly SSDI benefit amount.
SSI and Medicaid
In most states, SSI beneficiaries will automatically qualify for and receive Medicaid coverage. Medicaid is a national healthcare program that pays for medical expenses for individuals like those on SSI who have low income and few resources. Unlike the case for SSDI benefits, there is generally no waiting period to receive Medicaid benefits. No separate application for Medicaid is generally needed.
Some individuals receive benefits from both SSDI and SSI programs. These individuals are known as “dual eligible individuals,” and they receive benefits from both Medicare and Medicaid.
Muse Disability – Here For You
Sometimes, the process of seeking disability benefits can seem confusing and even overwhelming. But the good news is, it doesn’t have to be. Instead of feeling overwhelmed and wondering what to do, you can call the experienced and knowledgeable legal team at Muse Disability. We would love to learn about you and let you know how we can help. We understand the law and will always pursue the best legal strategies on your behalf. If you’re ready to get started, there’s no time like today. Give us a call soon. We look forward to speaking with you.