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SSI & Medicare Eligibility

Supplemental Security Income (SSI) is a federal benefit administered by the Social Security Administration. It is designed to help those with little income who cannot otherwise work. Unlike Social Security, it does not have a minimum work history requirement because it is not paid for with the Social Security taxes withheld from employment checks. Rather, it is funded by U.S. Treasury funds. Most SSI recipients are also qualified for Medicare, the federal health insurance program for the elderly and disabled.

  1. SSI Eligibility

    • To receive SSI, applicants must be either 65 years of age of older, blind or disabled. Furthermore, they must meet certain income and asset guidelines and citizenship requirements.

    Medicare Eligibility

    • Beneficiaries are not automatically qualified for Medicare just because they receive SSI benefits, unless they are receiving them because they are 65 and older or if they are receiving Social Security Disability Insurance. To receive premium-free Part A (hospital benefit), they must have worked at least 10 years in the United States at a job that paid into Medicare.

    Citizenship

    • For both Medicare and SSI, beneficiaries must be legal citizens or qualified aliens of the United States. The Social Security Administration defines a qualified alien as someone who meets criteria outlined by the Department of Homeland Security.

    Notification and Enrollment

    • Those on SSI insurance should receive a package in the mail three months before they are officially eligible for Medicare. This package will contain information about their Medicare benefits, along with the red-white-and-blue Medicare benefits card.

      Those who are on SSI before they become eligible for Medicare are automatically enrolled in Part A and Part B. Their Part B premiums are deducted from their SSI check. If they do not want Part B, they must actively opt out. The directions for doing this are included in the packet that is sent out before they are eligible that includes their Medicare card. If they do not want their Part B premium deducted from their check, they must contact Social Security and request to be billed for it instead.

    Private Plans

    • If SSI beneficiaries would rather enroll in a Medicare private health plan known as a Medicare Advantage plan or would like to enroll in a Part D plan, they must do so during their initial enrollment period. This is the seven-month period surrounding their eligibility month (three months prior, the month of, and three months following). If they do not make these changes during their initial enrollment period, they will have to wait until the annual coordinated election period to do so (November 15 to December 31 annually).

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