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Social Security Disability Income and Health Insurance

The number of Americans who are on disability has radically increased over the last three decades. Today, there are 14 million people receiving disability checks each month. Individuals who qualify for disability are those who have medical conditions that inhibit them from working in the labor force.

If you have a disability, there are options for health coverage. The Affordable Care Act plans are required to cover any individuals who have pre-existing conditions whether it’s a marketplace plan, Medicaid, or Medicare. An agent or broker can assist you with the application process and help you understand what you’re eligible for. Social Security Disability Income (SSDI) is applicable income to qualify and receive advanced tax credits for a private health insurance plan.

Once you’re approved for SSDI, there is a 24 month Medicare eligibility waiting period. In this interim period, you may be considered uninsured by the health care law and could potentially face a tax penalty. If you’re uninsured and collecting disability, the marketplace is a good place to start.

There are 2 options to ensure coverage (Marketplace or Medicaid):

  1. Call your agent to fill out a marketplace application. Select “yes” when asked if anyone on this application is disabled. The marketplace application will automatically be forward to Medicaid state agency
  2. Go apply directly to the Medicaid state agency

Completing the marketplace application is essentially knocking “two birds out with one stone”. If you’re eligible for Medicaid, then you can stay enrolled until the 24 month Medicare waiting period is over. If you’re denied from Medicaid, then you may be eligible for federal premium assistance towards a private health insurance plan. Take the private health insurance plan until Medicare kicks in. In fact, there is an exemption where you can keep the Marketplace plan as supplemental insurance to the Medicare, as long as you’re enrolled into it before Medicare. If you decided to keep the Marketplace health plan while enrolled into Medicare, you would no longer be eligible for tax credits.

In the situation that you’re waiting for results on your disability status or if you have Supplemental Security Income (SSI – not the same as SSDI), your best coverage options are to apply for Medicaid. Depending on the state, Supplemental Security Income (SSI) recipients automatically qualify and are guaranteed Medicaid eligibility. If you have SSI and are not enrolled in your state Medicaid program, you should call your agent for marketplace assistance.

At the end of the day, you may be surprised with your eligibility results. Every state has different Medicaid eligibility qualifications, especially the states that expanded Medicaid to the 138% Federal Poverty Line (FPL).See article on FPL chart.

For more information and a free consultation from a licensed health insurance agent call American Exchange at 1-888-995-1674.​

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