Any individual who is awarded Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) 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 or Medicaid, depending on the type of disability benefit the individual receives.

SSDI and Medicare

If you were awarded SSDI benefits, you automatically qualify for Medicare benefits. Specifically, you will receive what are 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 until you become eligible for Medicare. You will want to discuss your situation with a disability attorney to ensure you are getting all the benefits you’re entitled to.


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SSI and Medicaid

For disabled persons who receive SSI rather than SSDI, they will automatically qualify for Medicaid, another government health insurance program. Currently, over 8.8 million non-elderly individuals with disabilities have access to medical assistance through the Medicaid program, according to the Centers for Medicare & Medicaid Services.

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.

For help with getting medical benefits, SSDI, or SSI, call one of our disability attorneys at Chad Brown Law.  Call us today at (336) 962-5373 and schedule a free consultation.