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SSI Disability & Medicaid

The Social Security Administration (SSA) provides Supplemental Security Income (SSI) to the elderly and disabled who do not have a sufficient work history to collect full disability benefits and meet income and resource requirements. Medicaid is a federally- and state-funded, state-operated health insurance program for certain low-income individuals, including the elderly, disabled, pregnant women and children. Individuals who receive SSI are typically eligible for Medicaid.

  1. Income & Resources

    • SSI and Medicaid are both needs-based programs, meaning that recipients must fall under income and resource limits to be eligible for assistance from either program. Income and resource limits for Medicaid vary between states and depend on household size, type of Medicaid program and other factors. The resource limit for individuals who receive SSI is $2,000 and $3,000 for couples.

    Disability Determination

    • SSA conducts a disability review to determine eligibility for SSI based on disability. An individual must have a qualifying medical condition or have functional impairments that prevent gainful employment to qualify for SSI. Each state conducts a disability review process to determine eligibility for Medicaid. Disability requirements for Medicaid are similar to those set forth by the SSA for SSI eligibility.

    Automatic Eligibility for Medicaid

    • Residents of some states, such as California, are automatically eligible for Medicaid if they are currently receiving SSI. Residents of other states, such as Indiana, are not automatically eligible for Medicaid if they receive SSI and must complete the full application and disability review process.

    Work Incentives

    • Many states, such as Indiana, offer work incentives for individuals who receive Medicaid. Indiana offers MedWorks, a Medicaid program for the disabled who are employed. This program requires paying a premium for Medicaid that is based on income, with single adults earning less than $1,354 per month in 2010 being exempt from paying a premium. SSA offers the Ticket to Work program for disabled individuals who want to return to work. This program pays for supported employment services through state Vocational Rehabilitation programs and employment networks.

    Applying

    • You may apply for SSI at your local SSA office or online (see Resources). Contact your state's Medicaid office for specific instructions for applying for your state's Medicaid program.

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