Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) are disability benefit programs that provide income if an injury or medical condition prevents you from working. One concern that many people have when applying for disability is if their current health insurance affects SSDI or SSI. The good news is, your current health insurance should not affect your SSDI or SSI, nor should your disability benefits affect your current insurance plan.
That said, it is always a good idea to plan ahead when applying for disability. In terms of how your benefits will coexist with your private insurance, there are two things you should consider. First, either your current insurance or a Social Security plan—through Medicare or Medicaid—will function as your primary insurance. The other will serve as your secondary insurance. Which plan fills which position has implications that you should understand.
You should also be aware that qualifying for a non-governmental disability program—for instance, one offered through your employer or private insurance company—does not guarantee approval for SSDI or SSI benefits. However, mentioning it can strengthen your application since it establishes that a benefit-granting organization considers you disabled. A lawyer who specializes in disability benefits can guide you through this process.
The attorneys at the Disability Advantage Group, can help with your application and answer in more detail any questions you have about how your disability benefits and current health insurance will coexist. Call us at 865-566-0800 for a free consultation.
What Is the Difference Between SSDI and SSI?
The two main disability programs are SSDI and SSI. Both provide income to the disabled who cannot work, but that is where their similarities end. These are vastly different programs, particularly in terms of how you qualify for each.
SSDI is a government disability insurance program that draws its funding from workers’ payroll taxes. Every time you get a paycheck, a portion goes toward the Social Security program, which includes SSDI. If you later become disabled, you can file a claim to receive SSDI benefits, just as you would with other insurance programs. To qualify for SSDI, you must have a sufficient work history and have enough work credits based on your age.
SSI is a welfare program for the needy. Like other need-based programs, you do not qualify for SSI based on how much you have paid in, but on how substantial your need is. The program has income and asset limitations you must meet in order to receive benefits.
Your current health insurance should not affect your benefits from either program.
What Else Do I Need to Know About SSDI or SSI and My Current Health Insurance?
When you qualify for disability, you will effectively have two forms of insurance: your current health insurance plan and either Medicare or Medicaid. When you have more than one health insurance plan, one fills the position of primary insurer and the other is secondary.
Any time you visit the doctor or incur other health costs, your primary insurance pays first. Your secondary insurance covers remaining expenses after you max out your primary benefits. As a general rule, you want your private insurance as your primary plan if possible, with Medicare or Medicaid covering the remainder as your secondary plan. That way, you do not have to pay extra premiums for your Social Security plan.
The rules regarding primary and secondary insurance plans vary between Medicare and Medicaid. For Medicare, you may use your employer-based plan as your primary insurance if:
- Your employer has a staff of more than 100 people;
- You are under age 65; and
- You receive Medicare based on a disability.
Medicaid, on the other hand, always qualifies as your secondary insurance plan.
If your current health insurance does not qualify as a primary plan, then it will provide secondary coverage once you have used all your Medicare or Medicaid benefits. In this situation, it is a good idea to sign up for full healthcare benefits.
We can advise you of the best way to structure your health benefits based on what type of current health insurance you have and what you qualify for under disability.
At the Disability Advantage Group, we specialize in helping disability clients get the most out of their benefits. If you are applying for benefits and want to maximize your chances of approval—or you worry how your other public or private benefits might affect your disability benefits—call us for help. We can put our knowledge, experience, and resources to work for you.
The initial consultation is always free. Come in, sit down with us, meet our attorneys, have all your questions answered, and receive free legal advice on your disability situation. We look forward to meeting you. Call 865-566-0800 today for an appointment.