What Kind of Insurance Do People who Qualify for SSI Disability Get?

Supplemental Security Income (SSI) provides a monthly income to people unable to work for at least one year due to a serious medical condition or disability. To qualify for SSI, people must have limited income and limited resources. Since they cannot work, they cannot get health insurance through an employer as most people do. Since they have limited incomes, they may have trouble paying for medical care. Most people who qualify for SSI also qualify for Medicaid, a program available in all 50 states to help people access medical care.

Medicaid

• Medicaid provides a form of health insurance coverage to some people with limited incomes and limited resources. Criteria vary somewhat from state to state, but in all states people unable to work due to a disability can qualify if they meet specific income and asset guidelines. For instance, in 2009 Ohio residents who received SSI qualified for Medicaid if they earned less than $590 per month ($1,012 for a couple) and had less than $1,501 in assets ($2,251 for a couple). Some exceptions applied.

What It Covers

• Medicaid coverage varies slightly from state to state, but generally covers things such as inpatient hospital care, outpatient medical tests and visits to doctors, mental health treatment and prescription medications. It may cover dental care and eye care, as well. Recipients may have a co-pay or a deductible that applies to some services, depending on the policies in the state in which they live.

What It Doesn't Cover

• Medicaid only covers medically necessary procedures. For instance, it generally does not cover cosmetic surgery because doctors don't consider that medically necessary. In some states, it does not cover dental care for adults. In some states, it does not cover elective abortions. In addition, not all doctors accept Medicaid, so recipients may have difficulty obtaining some forms of medical care even if Medicaid does cover the treatment needed.

Applying for Medicaid

• People who qualify for SSI do not automatically receive Medicaid. They must apply for Medicaid at the Medicaid office in the county in which they live. The application procedure varies slightly from state to state, but people must complete an application form and provide proof of their income and assets. Other documentation may be required, as well.

Other Options

• Some people who qualify for SSI have other insurance options. If they are married, they may be able to obtain insurance through a spouse's employer. However, a spouse's income may disqualify from SSI benefits. An SSI recipient can purchase an individual insurance policy, but since people must have limited income and limited resources in order to qualify for SSI, they often can't afford private policies.