When a disabling medical condition prevents you from working, the benefits available from Social Security disability extend beyond monthly cash payments. As important as the monthly payments can be to relieving the financial pressures and hardship of a long-term disability, of equal importance is the medical insurance available through the Supplemental Security Income and Social Security Disability Insurance programs.
As you read through the information that follows about the insurance coverage available when you qualify for SSDI and SSI, keep in mind that help with disability applications and appeals is available. An SSD lawyer at Liner Legal Disability Lawyers has an unsurpassed knowledge of Social Security laws and procedures to guide you through what can be a complicated system to ensure that you get all of the benefits that you are entitled to receive.
Insurance Available Through SSI
Eligibility for the SSI disability program is based on the need of an applicant. The purpose of the monthly cash payments is for basic necessities, such as food and shelter, so your application must show that you have limited income and resources.
If you meet the financial guidelines and have a qualifying physical or mental impairment causing you to be disabled, the monthly benefits available through SSI for 2022 are $841 for an individual and $1,261 for a married couple where both spouses are eligible for benefits. Other income that you receive each month may reduce the monthly cash payment that you get through SSI.
Also available to SSI beneficiaries is coverage through the Medicaid program to pay all or some of your medical expenses. Medicaid is a state-administered program, which means that each state determines eligibility for its residents. Although federal law establishes eligibility guidelines that states must follow, it gives each state the authority to set its own standards that may, in some instances, be stricter than the federal guidelines.
Fortunately, most states automatically grant Medicaid eligibility to you when you qualify for SSI benefits. If you live in a state that does not automatically extend Medicaid coverage to you, you must submit an application through the agency administering it in your state. Speak with an SSI lawyer to learn more about what needs to be done.
There is no waiting period for health coverage through Medicaid to begin. Once you are approved, either automatically when you get SSI or by your state agency, your coverage begins.
Medicare and SSDI Benefits
If you worked and contributed to the Social Security system through taxes paid on earnings from a job or income earned through self-employment, a disabling physical or mental impairment that prevents you from continuing to work may entitle you to SSDI benefits. Disability benefits through SSDI include Medicare coverage to help pay for medical expenses.
Medicare coverage does not immediately go into effect upon being approved for SSDI. You must receive monthly benefit payments for at least 24 months before coverage begins. However, the 24-month waiting period is waived for SSDI beneficiaries diagnosed with amyotrophic lateral sclerosis, which you may know as Lou Gehrig’s disease or ALS.
Medicare has two coverages. Part A coverage, or Medicare Hospital Insurance, pays for medical care and treatment provided in a hospital setting. It does not pay for office visits and other services provided by health care providers when you are discharged from a hospital.
There is no charge for Medicare Part A coverage when you receive it as an SSDI benefit. You have the option to pay a monthly premium for coverage under Medicare Part B, which pays toward office visits and other medical services provided other than in a hospital.
Qualifying For Medicaid Coverage While Collecting SSDI
The monthly benefits payable through SSDI are calculated using a formula based on lifetime earnings from jobs and self-employment subject to Social Security taxes. Depending on how much you receive each month through SSDI, you may be eligible for Medicaid through your state.
If you qualify for Medicaid while getting SSDI payments, it remains your primary health insurance until you become eligible for Medicare. When that happens at the end of the 24-month waiting period, Medicare becomes the primary insurer and Medicaid remains as the secondary health insurance coverage.
Another insurance benefit that you may qualify for if you are eligible for both SSDI and SSI is assistance with payment of the Medicare Part B premium. An SSDI lawyer can check with the agency in your state to determine if it has a program paying Medicare Part B premiums for individuals qualifying for SSI who also qualify for Medicare through SSDI.
Learn More About Your Insurance Benefits
At Liner Legal Disability Lawyers, we take pride in our commitment to helping our clients obtain all of the SSD benefits available to them. Contact us today to schedule a free consultation and claim review with an SSD lawyer.