Does Social Security Disability Come With Medical Coverage?

by Karen Farnen ; Updated July 27, 2017
Access to Medicare can help people on SSDI pay for a variety of medical expenses.

People who collect Social Security Disability Insurance can receive Medicare coverage if they've been on disability long enough. Unlike Medicare for seniors, there's no age requirement for Medicare for the disabled. Only hospital insurance is free, but disabled people can also qualify for medical and prescription coverage through Medicare. In addition, private Medicare plans are available in many areas.

Qualifying for Social Security Disability

People who become too disabled to work for at least a year or whose disability may lead to death can qualify for Social Security Disability Insurance. Qualifying for SSDI requires sufficient work credits paying into Social Security -- usually at least 10 years of work.

The definition of "disability" for Social Security is strict. You must not be able to work at your previous occupation, and you must be unable to do other work because of your health condition. If you believe you qualify for benefits, you can apply online.

Obtaining Basic Medicare

Once you've been granted Social Security disability, you don't have to apply for Medicare. After you've been receiving disability payments for two years, the Social Security Administration enrolls you automatically in Medicare Part A, hospital insurance, and Part B, medical insurance. For example, Part B pays for outpatient hospital services and doctor bills. There's no age requirement.

Part A hospital coverage is free because it's paid for by payroll taxes. However, you must pay a monthly premium to accept enrollment in Part B medical coverage. Part B premiums are $104.90 monthly as of publication. Higher premiums are required from people with incomes over a certain amount; as of publication, the amount is $85,000 for those filing an individual or separate return and $170,000 for those filing a joint return.

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Part C and Part D Coverage

If you prefer, you can enroll for coverage through a Medicare Advantage plan from an insurance company, also called Part C. Advantage plans replace the hospital and medical coverage of original Medicare Parts A and B; some include additional benefits, such as prescription drug coverage. Types of Advantage plans include health maintenance organizations, HMOs and preferred provider plans.

If you have original Medicare A and B or if your Advantage plan doesn't include drug coverage, you can also purchase prescription coverage as Medicare Part D through an insurance company.

The premiums for Part C and Part D coverage depend on the particular company and your choice of plan.

Additional Costs and Getting Help

Medicare subscribers must also pay deductibles and other costs, such as co-payments. For example, as of publication, original Medicare has a Part A deductible of $1,260 for each benefit period and a Part B deductible of $147 each year. Costs such as co-payments for Part C and D coverage depend on the particular plan.

If you have low income and limited resources, you may qualify for help in paying your Medicare premiums and other costs. Apply for aid through a local or state welfare agency or through Medicaid.

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