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Disability-Based Medicaid

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    Disability-Based Medicaid

    How to Sign Up

    Application

    Depending on how you qualify for disability-based Medicaid, there are different ways to sign up.

    If you might qualify for Supplemental Security Income (SSI), you should apply for it, because it gives monthly cash payments and automatic Medicaid coverage. If you already have SSI benefits or have SSI 1619(b) status, you automatically have Medicaid and don't need to apply. Learn how to apply for SSI.

    If you don't already have SSI, you can apply for Medicaid directly. You can apply:

    Note: If you fill out a paper application, make sure to fill out Appendix A and select if you need State Supplementary Assistance or Medicaid waiver services.

    If you don't think you're eligible for Medicaid

    It is important to know that if you are not eligible for Medicaid, you may be able to get private insurance subsidized by the government.

    If you think you may not qualify for Medicaid, check out HealthCare.gov, an online one-stop shop where you can learn about your public and private coverage options. When you fill out an application on HealthCare.gov, it will check to see if you can get private coverage with subsidies. And if HealthCare.gov sees that you are eligible for Medicaid, your local Health and Human Services (HHS) office will contact you about enrolling.

    To learn more about getting government subsidies for private health plans, read DB101’s article about buying health coverage on HealthCare.gov.

    If you need help

    If you need help applying for Medicaid, try the following options:

    Staying on Medicaid

    When you have Medicaid and your situation changes, you need to report the change. Where you report the change depends on how you get Medicaid.

    If You Get SSI

    If you get Medicaid through SSI, your Medicaid coverage will continue as long as you get benefits. If your situation changes, like your income, resources, or living situation, it could affect your SSI benefits. Learn more about reporting changes to Social Security.

    If your benefits go down to zero because you go back to work, you may be able to keep your Medicaid coverage through SSI's 1619(b) rule. Learn more about getting Medicaid through 1619(b).

    If You Get Medicaid Another Way

    If you don't get Medicaid automatically through SSI or 1619(b), you will usually continue to get it for 12 months after you are approved if your situation does not change. Every 12 months, Medicaid will take a look at your situation and make sure you still qualify.

    If your income, resources, disability status, immigration status, residency, or household size changes, report the change to your local Health and Human Services (HHS) office. Your caseworker will tell you whether you will continue getting Medicaid or if you have new health coverage options. There will always be at least one health coverage option for your family.

    Example

    Joe had been getting SSI for several years when his health improved and he decided to go back to work. After he started working, his income increased to $4,255 per month ($51,060 a year) causing his monthly SSI benefit to drop to zero.

    Even though his income is now higher than the SSI income limit, he is still eligible for Medicaid through 1619(b) because his annual income is less than $52,860.

    Learn more

    Supplemental Security Income (SSI)

    SSI helps people with disabilities and seniors who have low income and resources.

    Medicare

    Medicare is public health coverage for people with disabilities and seniors.

    Medicaid for Employed People with Disabilities (MEPD)

    MEPD is Medicaid for people with disabilities who work.