If you’re disabled and unable to work, you need your medical coverage – but you also need your Social Security Disability (SSDI) benefits. Is it possible to qualify for both Medicaid and SSDI at the same time?
Yes, you can have both – assuming you continue to meet the state’s Medicaid (“SoonerCare”) income guidelines once your Social Security Disability benefits begin. That can be a literal lifesaver for many disabled people who rely on medication and treatment to keep their conditions in check.
Don’t I automatically get Medicare once my SSDI starts?
Medicare is the federal health insurance program designed to cover both adults over 65 years of age and younger people who receive Social Security Disability benefits. However, there’s a big catch: When your Medicare entitlement is based on disability, not age, you usually have a 24-month waiting period from the start of your SSDI entitlement before the coverage kicks in.
That means if you were entitled to benefits as of January 2022, you wouldn’t expect coverage under Medicare until January of 2024. For someone with chronic, disabling health issues, that would be an incredibly long time to go without any medical coverage.
This is usually where Medicaid eligibility comes in. Among the many differences between Medicaid and Medicare is the fact that Medicaid is tied both to disability and financial need. It’s also managed in partnership between the federal government and each state, so each state has its own criteria that it must follow in determining eligibility.
Those on Supplemental Security Income (SSI), which is another needs-based benefit, automatically qualify for Medicaid benefits. Those on SSDI do not – but Oklahoma has a fairly generous income allowance. If you’re in a household by yourself in 2022, for example, you can still qualify for SoonerCare with a monthly income of $2380 or less. Since the average SSDI benefit in 2022 is $1,358, most SSDI recipients qualify.
Trying to understand the way that various benefit programs like Medicare, Medicaid and SSDI interrelate can be confusing. Experienced legal guidance can help you get everything you are due and the benefits you need moving forward.