Will I Become Eligible for Medicare and Medicaid if I Win my Disability Case?

  Both Medicare and Medicaid are federal government programs that provide low or no cost health benefits to Americans.  However, the programs are fundamentally different.

  Medicare is tied to Social Security disability and Social Security retirement.  It is funded by taxes withheld from your paycheck during the time that you are working.  Once you become eligible, you may still need to pay a small premium for the coverage.  Medicare functions like a health insurance policy and directly pays your physician or hospital for covered services.

  If you are approved for Social Security disability, you automatically become eligible for Medicare 24 months from the date of your first disability payment.  Medicare will issue a certificate of eligibility that you can bring to your doctor.

  Medicaid is a need based program based on a claimant’s low income.  In this regard, Medicaid is tied to SSI, which also looks to household income for potential eligibility.  If your income situation changes, you can lose your eligibility for Medicaid.  You automatically become eligible for Medicaid if you are approved for SSI.

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