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Forrest Jackson of Jackson Law Firm

Social Security Disability and Medicare, Medicaid


If you are a recipient of Social Security Disability (SSDI) the good news is that you automatically qualify for Medicare. The not so good news is that there is a 24-month waiting period from the time you are eligible for disability benefits.

Calculating the Waiting Period

The 5-month waiting period from the time you become disabled, also known as the onset of the disability, makes a total of 29 months you would have to wait. Any time waiting for approval of your SSDI benefits however, does count towards that 29 month waiting period.

Exceptions to the waiting period

There is an exeption to the 24-hour waiting period for people with End Stage Renal Disease (ESRD) or Amyotrophic Lateral Sclerosis (ALS or Lou Gehrig’s disease). In these cases, Medicare becomes available at the time of SSDI eligibility.

Alternatives during the waiting period


Recipients of SSDI generally are not eligble to automatically receive Medicare. If you receive Supplimental Security Income (SSI) in all liklihood you will qualify for Medicaid, which is administered through the state in which you live. This is because SSI and Medicare both limit eligibility according to income and assets, which need to be below a certain amount. This amount will vary by state for Medicaid. If you receive SSDI and your income and assets are below the benchmarks for Medicaid, you would be eligible for Medicaid benefits.

COBRA Coverage

If you were working prior to your disability and your employer offered health insurance coverage, you would most likely be able to continue your coverage. However, the cost may be higher than what was coming out of your paycheck. In many cases employers cover a portion (and in some cases all) of your premium, but with COBRA coverage you would be responsible for the full amount of the monthly payment.

Private or ACA Health Insurance

In most cases, you cannot purchase your own health insurance plan outside of the open enrollment period. One exception to this is a life changing event such as a loss of employment that previously offered insurance or your job loss causes a you to fall into a lower income bracket, you can purchase health insurance through the open market or through your state's Affordable Care Act.

If you are receiving disability benefits and return to work, you can keep your Medicare coverage for 8-1/2 years. In some cases, you can keep your Medicare coverage even if your new employer offers health insurance.