How Soon Do You Get Medicare After Applying for SSI?

Different from Social Security benefits, which are based on an individual's work history, a person must have limited income and resources to be eligible for Supplemental Security Income. Unlike Social Security beneficiaries who receive Medicare to help pay for health care costs, SSI recipients receive Medicaid. However, in some cases, individuals who receive a low Social Security benefit may also qualify for SSI. These individuals may then be eligible immediately for Medicaid insurance, in addition to their Medicare.

Medicare vs. Medicaid

• Medicare is a health insurance program for Americans age 65 or older and for some people with disabilities. You automatically qualify to get Medicare Part A insurance once you are eligible to receive Social Security or Railroad Retirement benefits. Part A pays for inpatient hospital care. If you are eligible for Part A, you can sign up for Medicare Part B insurance, but you must pay a monthly premium. Part B pays toward doctor visits, outpatient hospital care and other medical services.

  Medicaid is a medical assistance program for individuals who have low incomes and limited resources. Both the federal and state governments fund this health insurance program. The program pays for doctor bills, hospital stays, prescription drugs and other medical services.

Qualifying

• Individuals who get SSI disability benefits are automatically eligible to receive Medicaid benefits as soon as they receive SSI. This is also the case for Medicare recipients who receive SSI or whose low incomes qualify them to get Medicaid as supplemental insurance to their Medicare. In some cases, Medicaid will pay unpaid medical bills dating back three months before you began receiving SSI benefits. Elderly individuals who receive Social Security retirement benefits and SSI may qualify for both Medicare and Medicaid health insurance.

Disability Recipients

• Although individuals who are approved for disability benefits are entitled to Medicare, there is a 24-month waiting period before Social Security Disability Insurance recipients under age 65 qualify for Medicare coverage. Added to the five-month waiting period from the onset date of the disability before a person can qualify for SSDI benefits, it can be 29 months before an individual who receives SSDI benefits is eligible for Medicare. Some exceptions to the 24-month waiting period apply. Often disability claimants are approved for benefits after the 29 months have already elapsed, making them eligible for Medicare coverage immediately. Disabled individuals who have little or no work history who do not qualify for Social Security Disability benefits may be awarded SSI and are eligible to receive Medicaid benefits instead. In that case, health insurance benefits are effective immediately.

Filing a Medicaid Application

• The Center for Medicare and Medicaid Services controls how the individual states administer their Medicaid programs. In most states, the SSI application is also the application form you must use to apply for Medicaid. Some states require that SSI recipients file a separate application for Medicaid. Most states that require applicants to complete a separate Medicaid application follow the same eligibility guidelines used for SSI. A few states use eligibility guidelines for Medicaid that differ from SSI rules.