How Do Disabled People Get Health Insurance?

A close-up of a disabled person in a hospital corridor.
A close-up of a disabled person in a hospital corridor. (Image: Naphat_Jorjee/iStock/Getty Images)

For people with temporary or permanent physical or mental disabilities, health insurance coverage they can afford and rely on is often a concern. While there are options available, there usually are eligibility requirements a person must meet. If private insurance or group health coverage isn't an option, there are low-cost and free programs available through the federal and state governments for disabled individuals who qualify.

Supplemental Security Income

Medicaid benefits are available to individuals with disabilities. In some states, individuals can apply for Medicaid when they apply for Supplemental Security Income -- a federal program that helps low-income, disabled individuals. In 32 states, the application is the same; therefore, qualifying for SSI benefits automatically makes an individual eligible to receive Medicaid health insurance. The Medicaid eligibility rules in some states differ from Social Security Administration rules and require a person to file for SSI and Medicaid separately. All states have disability and income requirements a person must meet to qualify for SSI and Medicaid.

Medically Needy Medicaid

Most states offer medically needy Medicaid programs to help individuals who do not qualify for Medicaid under the usual rules. For example, an individual might have income or assets that are slightly over the maximum the state allows. Some people receive Social Security Disability Insurance benefits but haven't yet met the 24-month disability requirement to receive Medicare. In some cases, an individual may be classified disabled in terms of state benefits but not for SSI or SSDI purposes.

Medicare Insurance

Medicare is available to individuals with disabilities who qualify. A person can get Medicare before age 65 after being eligible for benefits through SSDI for at least 24 months. Even with Medicare, however, supplemental coverage is needed, because Medicare will not pay for all services or for medical expenses in full. Many states also offer programs to help individuals with low incomes who cannot afford to pay the annual Medicare deductibles, monthly premiums, coinsurance and prescription drug co-pays on their own.

Health Care Benefits for Veterans

Individuals who served on active duty in a branch of the U.S. military are eligible to receive health care benefits through the Department of Veterans Affairs. When enrolling in the VA health care system, veterans are assigned to a priority group based on their need for the health care resources available. Veterans with service-connected disabilities, and disabled veterans who are not able to work because of service-connected disabilities and are receiving service-connected disability benefits get priority consideration for scheduling inpatient and outpatient medical care.

Protected by Affordable Care Act

People with disabilities don't always qualify for SSI or SSDI and therefore may not be eligible for public health insurance to cover their medical expenses. Fortunately, the Affordable Care Act offers disabled individuals additional options for heath care services and supports. One of the major benefits of the law is that it prevents private health insurers from discriminating against individuals who have pre-existing health conditions.

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