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Medicaid Disability and SSI: Knowing the Difference

Comparing Medicaid disability and SSI with each other is like comparing apples and oranges. Both are good to eat but they are essentially different.

Medicaid Disability

Medicaid Disability is a health insurance program that covers the beneficiary’s health expenses such as hospitalization, doctor’s fees, prescription medication, diagnostic and laboratory tests, as well as partial coverage on dental, vision and mental health treatments. It is not a cash payment but beneficiaries can go to the hospital and expect that Medicaid will pay a considerable portion of one’s hospital bills.

Medicaid Disability can work along with Medicare. In fact, Medicaid acts as a supplement for Medicare, taking up the slack for some benefits that are not covered by Medicare.

Medicaid is state-run and that usually means processing of applications are faster. For Medicaid, benefits may vary depending on the state, since the state also has the discretion to add to the standard list of benefits. Also, eligibility and implementing rules may also differ from state to state.

How are Social Security and Medicaid different?

Medicaid Disability is run by the country and usually has a quicker application process. Social Security is conducted by the federal government through local offices.

Medicaid only provides medical benefits. Social Security provides direct payment.

For both programs, your disability must substantially harm your ability to work. Both Social Security and Medicaid require that your disability is expected to last for at least 12 months.

How are Social Security and Medicaid alike?

Both applications require a written application, the review of your medical records, and maybe even a medical exam. You have the right to look at your case file at any time. For the two programs, your disability must substantially damage your capacity to get the job done. Both applications require that your disability is expected to continue for 12 or more weeks.

Both programs conduct regular reviews to determine if you are still eligible for benefits.

Both programs give you the right to appeal if you disagree with a decision affecting your benefits, and the right to reapply as many times as you want.

medicaid disabilityWhat are the requirements for Medicaid?

Generally, when and if you’re deemed eligible for Medicaid, you can hold on to those benefits for life. Medicaid is need-based, which means no matter how much money you make, you are qualified to Medicaid disability benefits. You can continue receiving Medicaid benefits so long as the conditions determined by the Social Security Administration are met:

  • You have a disability;
  • You meet all the SSI eligibility requirements, except for earnings;
  • You were eligible to receive a regular SSI cash payment for at least one month before you became eligible under
  • Section 1619 of the Social Security Act;
  • You need to Medicaid to continue working; and
  • Your earnings could not replace the value of your SSI cash benefits, your Medicaid benefits, and any publicly funded personal or attendant care you receive that would be lost due to your earnings

Of course, due to the fact that Medicaid is controlled primarily by the states, the exact requirements are different based on where you live. While typically you will never be denied Medicaid so long as you continue to meet these conditions, the amount you may receive may very well differ depending upon your income and assets.

Supplemental Security Income

The federal Supplemental Security Income (SSI) program provides monthly cash assistance to people who are disabled, blind, or elderly and have little income and few resources. In December 2013, nearly 8.4 million individuals collected SSI benefits.

Although run by the same agency, SSI is distinct from the Old-Age, Survivors, and Disability Insurance (OASDI) programs. Nevertheless, the two programs often overlap. Many SSI recipients have worked long enough to collect Social Security but their Social Security benefit is low enough that they also qualify for SSI. Nearly one-third of adult SSI recipients under age 65, and almost three-fifths of recipients over 65, also get Social Security.


Both require that the beneficiaries have a certain level of revenue. Additionally, you must show that the disability for which you’re applying has substantially resulted in your inability to work.

Both require you to submit medical documents, in addition to other proofs of your handicap. When you gain eligibility for benefits, Social Security and Medicaid may conduct occasional reviews for these organizations to determine whether you remain eligible for the benefits.

The great thing with Medicaid and SSI is that though they’re distinct programs, you can have these at the same time.

Read More: Disability Payment and How to Determine Maximum SSDI Benefits