MEDICARE VS. MEDICAID

When you are approved for Social Security disability benefits, you will usually be approved for either Medicare or Medicaid.  Which one depends on whether you receive SSI (which comes with Medicaid) or SSDI (which comes with Medicare).

Medicaid is a state insurance program and is offered to certain persons with very limited financial resources and low household income.  Medicaid is provided with Supplemental Security Income (SSI) benefits.

Medicare is a federal insurance program available to persons who have reached age 65 or who have been awarded SSDI (Title 2) benefits.  There are no financial or income limits for Medicare.

Medicaid has no waiting period.  It is available as soon as SSI payments are paid. 

Medicare, on the other hand has a 29-month waiting period.  This includes a mandated 24-month Medicare waiting period, plus the 5-month waiting period to receive SSDI payments.  Here is an example of how the Medicare waiting period works.

• Date of established disability under Title 2:  March 3, 2016
• Benefits become payable after 5 full months on Sept. 1, 2016.
• Medicare becomes available 24 months later on Sept 1, 2018.

Note:  If a disabled person reaches age 65 while waiting for Medicare eligibility, Medicare begins the month during which the individual becomes age 65 (even if 29 months of disability have not passed yet).

So, the simple rules are:

Medicaid has no waiting period and becomes available as soon as your SSI (Title 16) payments begin.

Medicaid has a 29-month waiting period and becomes available 29 months following your *established date of disability.  This is usually NOT the same date as your decision or hearing date.
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