How SSD, SSI, And Medicare Work Together
In 2016, nearly 10.2 million people in the United States were paid disability benefits. About one out of six disabled beneficiaries received Supplemental Security Income (SSI) as another source of income. In fact, nearly 200,000 residents in Tennessee received SSI benefits in 2018.
Many people rely on SSD and SSI benefits in the U.S., which is why it’s important to understand how they work in relation to Medicare and Medicaid.
Though a disability benefits lawyer can best help you understand these programs more easily, The Law Offices of Michael Hartup put together an overview of how Medicare, Social Security Disability (SSD) benefits, SSI, and Medicaid work together.
How does Medicare work with SSD?
Medicare is a federal health insurance program for people age 65 or older. People younger than 65 with certain disabilities or permanent kidney failure may also qualify for Medicare. Medicare helps with the cost of health care, but it doesn’t cover all medical expenses or most long-term care.
After you get SSD benefits for two years, the Social Security Administration (SSA) automatically enrolls you in Medicare. You’re enrolled in hospital insurance (called Part A) and medical insurance (Part B). Hospital insurance helps pay for hospital bills and some follow-up care, while medical insurance helps pay doctors’ bills, outpatient care, and other medical services.
What about SSI and Medicaid?
SSI is another federal program run by the Social Security Administration. SSI and SSD share many similarities, but there are differences in eligibility and funding. SSI is funded by general tax revenues and is a need-based program for low-income individuals. SSI benefits are based on the Federal Benefit Rate, while SSD benefits are based on a worker’s lifetime average earnings.
While the eligibility relationship between SSD and Medicare is fairly simple, understanding eligibility for SSI and Medicaid can make it more complicated. Medicaid is not the same as Medicare.
Medicaid is an assistance program that serves low-income people of every age. While a small co-payment is sometimes required, patients usually pay no part of costs for covered medical expenses. It’s a federal-state program and varies from state to state.
In most states, if you receive SSI, you may be automatically eligible for Medicaid. The SSA determines Medicaid eligibility for residents in Tennessee, meaning you’ll most likely be granted Medicaid when you’re approved for SSI based on disability. In some states, your eligibility means you don’t have to apply for Medicaid; in other states, that means you are eligible, but you must sign up for it.
In a few states, SSI doesn’t guarantee Medicaid eligibility. If you must apply for Medicaid coverage, select your state on the healthcare.gov site and find your Medicaid agency’s contact information.
Our Social Security Disability attorney can help
You’re not required to work with a lawyer to seek disability benefits, but an experienced SSD attorney can ensure your application is properly filled out and filed. Your attorney can also support you in the event that your initial application is denied, an attorney can help you gain a successful appeal. This can mean the difference between receiving benefits and not: every year, about 60 percent of applications are denied. We don’t want you to be one of those applicants.
Attorney Michael Hartup represents individuals seeking Social Security Disability benefits or compensation.
Disability law and Medicare can be confusing, which is why our team can help you pursue your benefits and work through the claims process. Call the Law Offices of Michael Hartup at our Jackson, TN office at 731-424-5559. You can also fill out our contact form online.