In the American Social Security Disability system, the disabled have the option of two ways of utilizing disability benefits. Of the types of insurance is known as Medicare and the opposite is known as Medicaid. While both of these programs provide medical insurance, the way the application for each works and the eligibility criteria are different for both programs.

Before we go on to see if Medicare and Medicaid come with Disability, let us see what each means:

Medicare

Medicare is an extensive coverage insurance program. By paying into the Social Security taxes, you are actually paying into this system that ultimately pays for your Medicare coverage. You are eligible to receive Medicare when you attain full retirement age (63 to 65 or above) or end up being disabled. Medicare payments are paid through a trust fund paid into by means of people who are protected in this system i.e., people who paid enough Social Security taxes.

Good news is there are no income limits to qualify for Medicare benefits. Patients who are not yet retired or reached age 65, but are disabled can begin to receive Medicare benefits 12 months after they have been qualified and began receiving the Social Security Disability benefits.

Medicare is break up into 4 separate additives—Part A, Part B, Part C and Part D:

  • Medicare Part A affords hospitalization insurance
  • Part B works like regular medical health insurance. It covers physician's visits, lab paintings and visits to the emergency room
  • Part C is privately bought supplemental coverage that offers extra coverage beyond what Part A and B cover
  • Part D offers prescription drug insurance

Medicaid

As opposed to Medicare, the Medicaid is a need-based disability program. Through Medicaid, the clinical bills are paid through federal, state or local taxes. This program serves workers mostly with low-wage earnings. There is no hard criteria for age limit or eligibility for the program. Patients who obtain Medicaid usually no longer need to pay for any medical expenses related to their disability, however a small co-payment may be required for other services.

Unlike Medicare, which is run under the federal rule, Medicaid is run at the state level with federal guidelines. Since it is a need-based program, there is an income eligibility threshold limit that needs to be met to apply for the benefits.

Almost all Medicaid insurance allows for hospitalization, laboratory services, x-rays, physician services, own family planning, nursing offerings, clinical and surgical dental offerings, medical institution treatment, pediatric offerings and screening services. Some states additionally allow for the insurance of optometrist services, dental offerings and medical transportation.

Does Medicare and Medicaid come with SSDI?

The answer to that is yes, disabled people who have qualified for the Social Security Disability Insurance, SSDI are eligible to receive benefits with Medicare, however, people qualified for the Supplemental Security Income, SSI will receive benefits with Medicaid.

While that is the case normally, in some rare cases people receive concurrent benefits – people who qualify for both SSDI and SSI incomes are eligible to receive both Medicaid and Medicare benefits.

Click here to read why you have difficulty qualifying for SSDI

For people qualifying for Medicare, it offers some 'extra help' for the claimants by paying for their prescription drug costs. The application is online at www.socialsecurity.gov/prescriptionhelp.


If you are a claimant with concurrent benefits or are someone having difficulty in understanding whether you qualify for Medicare or Medicaid benefits, you should consider contacting a local Social Security Attorney in California near you.