Do I get Medicare or Medicaid if I win my Social Security disability case?

Generally, people get Medicare when they win a claim for disability and they receive Medicaid when they win a claim for SSI – but some people get both.

To learn about how Medicare works if you are disabled, visit the website for CBIGCBIG is owned by Chad Brown and specializes in helping the disabled understand Medicare.

Generally, an individual who is awarded Social Security Disability Insurance benefits (SSDI) will automatically be enrolled in a government-sponsored health insurance plan after a 24-month “qualifying period.” Social Security disability medical benefits are offered via Medicare. Individuals that are awarded Supplemental Security Income benefits (SSI) are awarded Medicaid which starts the first month they are eligible for SSI benefits.

SSDI and Medicare

If you were awarded SSDI benefits, you automatically qualify for Medicare benefits. Specifically, you will receive what is referred to as Part A and Part B Medicare benefits, which covers the following:

  • Hospital care and ambulance services;
  • Skilled nursing facility care;
  • Nursing home care;
  • Hospice;
  • Home health services;
  • Clinical research;
  • Preventative services;
  • Durable medical equipment;
  • Mental health both inpatient and outpatient;
  • Second opinions prior to surgery; and
  • Certain outpatient prescription drugs.

As mentioned above, there is a two-year qualifying period for your Medicare to take effect. Specifically, you will receive Medicare benefits two years after your SSDI entitlement date, which is five months after the date you became disabled. If you are disabled and in need of medical care in the interim, you may be able to obtain coverage under Medicaid or possibly the Affordable care Act. You will want to discuss your situation with a disability attorney to ensure you are getting all the benefits you’re entitled to. Chad Brown Law works with CBIG, LLC, a Medicare specialty insurance agency to make sure all of its clients are able to maximize their benefits under Medicare.

SSI and Medicaid

For disabled persons who receive SSI rather than SSDI, they will automatically qualify for Medicaid, another government health insurance program. Some claimants are eligible for both Medicare and Medicaid. The type of benefits offered by Medicaid varies from state to state. For example, some states may cover occupational therapy, dentures, and chiropractic care while others don’t. However, the federal government has a list of mandatory benefits that all states must provide in their Medicaid program. These include the following:

  • Inpatient and outpatient hospital services;
  • Early and Periodic Screening, Diagnostic, and
  • Treatment Services (EPSDT);
  • Physician services and nursing facility services;
  • Home health services and rural health clinic services;
  • Lab work and X-ray services;
  • Family planning services;
  • Midwife and birth center services;
  • Certified Pediatric and Family Nurse Practitioner services;
  • Transportation to medical care; and
    Tobacco cessation counseling for pregnant women.

Questions about access to medical care while disabled? Contact us today.

If you need help with a disability case, or you have won your disability case and need help understanding Medicare, call Chad Brown Law today at (336) 546 -5066.

Chad Brown Law is unique in that it is one of the few law firms in the country that helps disability recipients understand Medicare – even if we did not represent you in your disability case. If you have Medicare because you have Social Security disability benefits and have questions, call or contact us today. 

Additionally, if you would like a free assessment of how to best navigate Medicare on disability, we recommend you call CBIG to receive a free Medicare evaluation.

Our firm focuses on three practice areas: Disability, Personal Injury, and Eminent Domain. Every practice area has attorneys who have expertise in their respective area of practice. 

Chad Brown is a North Carolina Board Certified Social Security disability law specialist. Mr. Brown helps Social Security disability claimants at all stages of the disability process. He also works with people that have Long Term Disability denials and with people that are injured by drugs and defective medical products.

Your Questions Answered

Do I need to tell SSA everything I did in my prior jobs?

The short answer is – Yes. Claimants must prove they cannot perform any job they regularly performed in the past 15 years to obtain Social Security disability benefits. When you apply for disability, you will be asked to list your previous work history. If you do not...

read more

What happens if I cannot afford medical treatment?

If you cannot afford medical treatment, winning your case could be difficult. You may, in fact, have disabilities that prevent you from working, but you have to be able to prove this to the Social Security Administration. You need to provide solid, medical evidence...

read more

Free Consultation