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I’m Disabled… Can I get Medicaid or Medicare?

If you are found disabled then, yes, you will be eligible for either Medicaid or Medicare, depending upon your disability application type.

Medicare is a federally based health insurance program. There are three ways to qualify for Medicare:

  1. You are 65 or older;
  2. You suffer from end-stage renal disease or ALS; or
  3. Social Security finds you disabled.

If you are younger than 65 but don’t suffer from ALS or end-stage renal disease, then to be eligible for Medicare your best option would be to apply for Social Security Disability benefits. To qualify for this program you need to show that you suffer from a severe physical and/or mental condition that prevents you from performing your past work along with any other types of work in the national economy. You must be found disabled for more than 24 months before you may become eligible for Medicare.

Medicaid is a health insurance program for families and individuals with low income and limited resources. Typically, these programs are administered through the state. Poverty alone will not necessarily qualify you for this program. Oftentimes, it depends on the State to make an eligibility determination. However, if you are found disabled then you will qualify for Medicaid. Unlike Medicare, if you have been approved for disability benefits, you will be immediately eligible to receive Medicaid.

Oftentimes, individuals may only qualify for Medicare or Medicaid through a finding of disability. Usually, an individual who is turned down for Medicaid or Medicare will then seek to qualify through disability. But if that same individual is trying to obtain other health insurance programs then, more than likely, they don’t currently have health insurance. This is important is because to qualify for disability benefits you need to show you suffer from a severe physical and/or mental condition. Proving the severity of your conditions is predicated on recent medical treatment documenting your conditions.

So what are you supposed to do if you are denied Medicaid/Medicare, and you don’t have recent medical treatment to support a disability finding? Your best option is to either apply for the Affordable Care Act. Or, depending upon the area in which you live, there may be either free or low-cost clinics where you can obtain treatment. Another option would be to contact your local hospital and ask to speak with a social worker on staff. A social worker may be able to guide you in the right direction of obtaining some type of medical treatment for your conditions.

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