Health Insurance and Social Security Disability

Health Insurance and Social Security Disability

Social Security pays benefits to those who are disabled (i.e., unable to work full time due to medical conditions). Because of this, those applying for such benefits (“claimants”) are often without health insurance, making it difficult to treat for the very conditions which prevent them from working. Obviously, they cannot get insurance through an employer, and insurance through a spouse or family member, if available, may be cost prohibitive. Therefore, it is natural to wonder how they can get insurance, and thus the treatment, that they desperately need.

While claimants are waiting for disability, Social Security does not offer health insurance or treatment options of any kind. Thus, the burden is on the claimant to find a way to see doctors and get medicine and other treatment. Obviously, this can be quite difficult for someone who is unable to work. However, there are some options available. First and foremost is Medicaid. This is a health insurance program offered by the government for people with limited income and resources. The requirements to qualify vary from state to state, but generally if you have little to no income, or are on other government assistance, there is a good chance that you will qualify. To find out for sure, however, you can go to healthcare.gov to find out where to apply in your state.

Another option, if you don’t qualify for Medicaid, is to look for a free clinic in your area. Often, these places will treat low income people on a sliding scale, or even for free in some circumstances.

Lastly, if possible, insurance can be purchased at healthcar.gov. Again, as claimants are unable to work, and therefore unlikely to be able to afford to pay for insurance, Medicaid or free clinics are the best places to start. However, because those are income based, occasionally a claimant may not qualify, even if they are not working, due to other income or assets, such as a spouse’s income, or a pension from a prior job. If this is the case, then buying private insurance may be the only option available.

Once a person is approved for disability, there options for insurance may change, although not necessarily. The available coverage varies depending on the type of disability one is awarded, i.e., disability insurance benefits (“DIB” or “SSDI”) or supplemental security income (“SSI”). If you are receiving SSDI benefits (disability paid to those who have worked enough to be eligible), you will automatically be eligible for Medicare, which is insurance for those who are age 65 and older, but also those her are disabled. The problem is, this insurance does not kick in until one has been disabled for at least 29 months. Thus, there may be a gap before it kicks in, and the options above (Medicaid, Free Clinics, or private insurance), may still be one’s best option while waiting.

SSI does not come with health insurance, so again, the above choices may again be the only options. Whatever the case, treatment for medical conditions is imperative; not just for the obvious reason that one’s life could depend on it, but also because Social Security requires proof of disability, and treatment is the only way to generate this proof.

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