if i get ssi and medicaid in alabama why dont i get medicare

People who receive Supplemental Security Income

(SSI) are not qualified to receive Medicare insurance coverage until they reach the age of sixty-five. (Instead, they are eligible for Medicaid.) However, upon turning 65, SSI recipients can receive Medicare based solely on age.

Full Answer

Do I get Medicare if I'm approved for disability benefits?

If you're approved for disability benefits, you'll also get Medicare or Medicaid, depending on whether you receive SSDI or SSI benefits. Disabled people who are approved for Social Security disability insurance (SSDI) benefits will receive Medicare, and those who are approved for Supplemental Security Income (SSI) will receive Medicaid.

Does Alabama Medicaid have Medicare coverage?

Alabama Medicaid has three programs for people who have Medicare coverage: The Qualified Medicare Beneficiary (QMB) program, the Specified Low-Income Medicare Beneficiary (SLMB) program, and the Qualifying Individual (QI-1) program. The services you get depend on how much income you have.

Is Social Security linked to Medicare or Medicaid?

SOCIAL SECURITY, MEDICAID AND MEDICARE. Medicaid is linked to receipt of SSI benefits in most States. Medicare is linked to entitlement to Social Security benefits. It is possible to get both Medicare and Medicaid. States pay the Medicare premiums for people who receive SSI benefits if they are also eligible for Medicaid.

Do you have to pay Medicaid if you have SSI disability?

You won’t have to pay the penalty that people without coverage must pay. If you get SSI Disability and don’t have Medicaid. You can apply for Medicaid coverage. In many states, SSI recipients automatically qualify for Medicaid and don’t have to fill out a Medicaid application.

Do you automatically get Medicare with Social Security?

If you are already getting benefits from Social Security or the RRB, you will automatically get Part A and Part B starting on the first day of the month when you turn 65. If your birthday is on the first day of the month, Part A and Part B will start the first day of the prior month.

Who is eligible for Medicare in Alabama?

65 or olderMedicare is health insurance for people 65 or older. You're first eligible to sign up for Medicare 3 months before you turn 65. You may be eligible to get Medicare earlier if you have a disability, End-Stage Renal Disease (ESRD), or ALS (also called Lou Gehrig's disease).

How is Medicare linked to SSI?

Social Security and Medicare are distinct programs serving older and disabled Americans, but they have an important commonality: Social Security handles enrollment for Medicare Part A (hospital insurance) and Part B (medical insurance).

Can you have Medicare and Medicaid?

Medicare-Medicaid Plans Medicare is working with some states and health plans to offer demonstration plans for certain people who have both Medicare and Medicaid and make it easier for them to get the services they need. They're called Medicare-Medicaid Plans.

What is the income limit for Medicare in Alabama?

Coverage may begin up to 3 months prior to the application month, if you meet the requirements. SLMB Income limits: $1,153.01 – 1,379.00 per month (gross) for individuals who are single, widowed, divorced, or separated, $1,546.01 – 1,851.00 per month (gross) for a couple.

How much is Medicare in Alabama?

Medicare in Alabama details The average Medicare Advantage monthly premium decreased in Alabama compared to last year — from $11.19 in 2021 to $11.21 in 2022.

How much does Social Security take out for Medicare each month?

The standard Medicare Part B premium for medical insurance in 2021 is $148.50. Some people who collect Social Security benefits and have their Part B premiums deducted from their payment will pay less.

How do I get Medicare and Social Security at the same time?

Ready To Start Medicare? If you'll turn 65 within three months, you can use our online application to apply for Medicare and Social Security retirement benefits at the same time, or you can use it to apply for just Medicare. To learn more about your Medicare options, review our section on Medicare Benefits.

Do you apply for Social Security and Medicare separately?

Medicare and Social Security are two separate programs, but the Social Security Administration runs enrollment for traditional Medicare. You can enroll in Medicare parts A, B and D (prescription-drug coverage) as early as three months before the month you turn 65 or as late as three months after the birthday month.

Who is not eligible for Medicare Part A?

Why might a person not be eligible for Medicare Part A? A person must be 65 or older to qualify for Medicare Part A. Unless they meet other requirements, such as a qualifying disability, they cannot get Medicare Part A benefits before this age. Some people may be 65 but ineligible for premium-free Medicare Part A.

How do I know if I have Medicare?

Your enrollment status shows the name of your plan, what type of coverage you have, and how long you've had it. You can check your status online at www.mymedicare.gov or call Medicare at 1-800-633-4227.

Can I get Medicare Part B for free?

While Medicare Part A – which covers hospital care – is free for most enrollees, Part B – which covers doctor visits, diagnostics, and preventive care – charges participants a premium. Those premiums are a burden for many seniors, but here's how you can pay less for them.

Who qualifies for Medicaid in Alabama?

Income & Asset Limits for Eligibility2022 Alabama Medicaid Long Term Care Eligibility for SeniorsType of MedicaidSingleInstitutional / Nursing Home Medicaid$2,523 / month*$2,000Medicaid Waivers / Home and Community Based Services$2,523 / month†$2,000Regular Medicaid / Medicaid for Elderly and Disabled$861 / month$2,0001 more row•Feb 7, 2022

Does Alabama have free health insurance?

Quick Info. Medicaid provides free or low-cost health coverage to eligible needy persons.

What does Medicare cover in Alabama?

Medicare Part A - Provides services associated with hospital, hospice, skilled nursing care and home healthcare. Medicare Part B - Covers physicians, outpatient hospital care and many other services typlically covered under health insurance plans.

How do I apply for Medicare in Alabama?

Online (at Social Security) – It's the easiest and fastest way to sign up and get any financial help you may need. (You'll need to create your secure my Social Security account to sign up for Medicare or apply for benefits.) Call Social Security at 1-800-772-1213. TTY users can call 1-800-325-0778.

Supplemental Nutrition Assistance Program (Formerly "Food Stamps")

The Supplemental Nutrition Assistance Program (SNAP) provides help for low-income households to buy the food needed for good health. In most states...

Temporary Assistance For Needy Families (TANF)

The TANF program provides cash block grants to states. TANF gives states the flexibility to determine TANF eligibility rules and to set TANF paymen...

Affordable Health Insurance For Children Who Need It

Medicaid provides free health coverage to most low-income children through state children's health insurance programs. Contact your local state or...

State Or Local Assistance Based on Need

Some states offer state or local assistance based on need to aged, blind, and disabled people through the state welfare department. The state may r...

Social Security, Medicaid and Medicare

Many people receive both SSI and Social Security benefits.Medicaid is linked to receipt of SSI benefits in most States. Medicare is linked to entit...

State Programs That Help With Medicare Costs

You may qualify for help with certain Medicare costs under the programs below if:you receive Medicare;your income and resources are limitedThese li...

What is SSI disability?

Supplemental Security Income (SSI) Disability & Medicaid coverage. Waiting for a disability status decision and don’t have health insurance. No disability benefits, no health coverage. The Marketplace application and disabilities. More information about health care for people with disabilities.

Do you have to fill out a Medicaid application if you have SSI?

In many states, SSI recipients automatically qualify for Medicaid and don’t have to fill out a Medicaid application. In other states, your SSI guarantees you Medicaid eligibility, but you have to sign up for it. In a few states, SSI doesn’t guarantee Medicaid eligibility. But most people who get SSI are still eligible.

Can I apply for medicaid if I don't have SSI?

If you have SSI Disability and don’t have Medicaid, you can apply for Medicaid coverage 2 ways: Select your state from the menu on this Medicaid page for contact information. Create an account or log in to complete an application. Answer “yes” when asked if you have a disability, and we’ll send your application to your state Medicaid office.

Do you have to apply for medicaid if you have SSI?

If you have Supplemental Security Income (SSI) Disability, you may get Medicaid coverage automatically or you may have to apply.

What happens if you approve for SSI?

If we approve you for SSI, your State or local public assistance payments will usually stop. Your State may be entitled to collect part of your retroactive SSI benefits as repayment for the money they paid you while we processed your SSI claim.

How to get a phone number for Medicaid?

To get the phone number for your State Medicaid office, visit Medicare.gov/contacts online. First, choose your state under “Choose your location for contact information,” and then, under “Choose an organization OR topic of interest,” select “State Medical Assistance Office” at the bottom of the list of options.

What is QMB Medicare?

The QMB program helps low-income Medicare beneficiaries by paying Medicare Part A and/or Part B premiums. Medicare providers are not allowed to bill you for Medicare deductibles, coinsurance, and copayments.

What is Supplemental Security Income?

SUPPLEMENTAL SECURITY INCOME (SSI) AND ELIGIBILITY FOR OTHER GOVERNMENT AND STATE PROGRAMS. Many people who are potentially eligible for SSI benefits do not know how receiving SSI affects their benefits or payments from other government and State programs.

Can you get Medicare and Social Security?

SOCIAL SECURITY, MEDICAID AND MEDICARE. Many people receive both SSI and Social Security benefits. Medicaid is linked to receipt of SSI benefits in most States. Medicare is linked to entitlement to Social Security benefits. It is possible to get both Medicare and Medicaid. States pay the Medicare premiums for people who receive SSI benefits ...

Can I apply for medicaid if I have SSI?

In most States, if you are an SSI recipient, you may be automatically eligible for Medicaid; an SSI application is also an application for Medicaid. In other States, you must apply for and establish your eligibility for Medicaid with another agency. In these States, we will direct you to the office where you can apply for Medicaid.

Does QDWI pay Medicare?

The QDWI program will pay Medicare Part A premiums only. If you are under age 65, disabled and no longer entitled to free Medicare Hospital Insurance Part A because you successfully returned to work, you may be eligible for a State program that helps pay your Medicare Part A monthly premium.

Do Medicare benefits depend on income?

The services you get depend on how much income you have. These programs pay Medicare premiums, and in some cases, Medicare deductibles and co-insurance. There are some people called “dual eligibles” who receive full coverage under both programs.

Can I get medicaid in Alabama?

Can I have Medicare and Medicaid? Yes. Alabama Medicaid has three programs for people who have Medicare coverage: The Qualified Medicare Beneficiary (QMB) program, the Specified Low-Income Medicare Beneficiary (SLMB) program, and the Qualifying Individual (QI-1) program.

Does medicaid pay for co-payments?

For Qualified Medicare Beneficiaries (QMBs) Medicaid pays the Part B premium and also covers co-payment and deductibles. Recipients who qualify for the Specified Low-Income Medicare Beneficiary (SLMB) or the Qualified Individual - 1 (QI-1) programs are eligible to have Medicaid pay their monthly Part B premiums.

Can you get a refund for medicaid premiums?

Recipients will only receive a refund for premiums that were charged to the recipient and paid by Medicaid. A refund will not be issued for months the recipient was not on a Medicaid program that pays the Medicare premiums.

What is Medicaid in Alabama?

Medicaid is a wide-ranging health insurance program for low-income individuals of all ages. Jointly funded by the state and federal government, it provides health coverage for diverse groups of Alabama residents, including pregnant women, parents and caretaker relatives, adults with no dependent children, disabled individuals, and seniors.

How long does Alabama have a look back period for medicaid?

This is because Alabama has a Medicaid look-back period, which is a period of 60 months (5 years) that dates back from one’s Medicaid application date. During this time frame, Medicaid checks all past transfers to ensure no assets were sold or given away for less than they are worth.

What happens if you violate the look back period for Medicaid?

If one is found to be in violation of the look-back period, a penalty period of Medicaid ineligibility will ensue. For long-term care Medicaid eligibility, an applicant’s level of care need is also considered. For nursing home Medicaid and many HCBS Medicaid Waivers, a nursing facility level of care (NFLOC) is required.

When only one spouse of a married couple is applying for nursing home Medicaid or a HCBS waiver, is

When only one spouse of a married couple is applying for nursing home Medicaid or a HCBS Medicaid waiver, only the income of the applicant is counted. Said another way, the income of the non-applicant spouse is disregarded.

Does Medicaid give away assets?

As with the income allowance rule, this asset allowance does not apply to married couples with one spouse applying for regular Medicaid. It is vital that one does not give away assets or sell them for less than fair market value in an attempt to meet Medicaid’s asset limit.

Can a well spouse apply for Medicaid?

To be clear, this rule does not apply when only one spouse of a married couple applies for regular state Medicaid.

Is income counted differently when applying for Medicaid?

For clarification purposes, it is important to mention that income is counted differently when one spouse of a married couple is applying for Aged, Blind and Disabled Medicaid. In this case, the income of both the applicant spouse and the non-applicant spouse is calculated towards the income eligibility of the applicant.

What is SSDI in Alabama?

SSDI is an insurance program that working-age Americans pay premiums for through paycheck deductions. Once you turn 65, any Alabama disability payments you get through SSDI convert into regular Social Security checks.

What happens to disability benefits in Alabama?

Once you reach full retirement age, your Alabama disability benefits convert into regular Social Security retirement. You’ll get paid the same amount and don’t need to complete any paperwork to make this happen.

How long does it take to get SSDI in Alabama?

Legally, no lawyer can charge you anything until after the SSA’s already approved you for Alabama disability benefits. Today, SSDI applications for Alabama disability benefits take 558 days to process, on average. That’s over 18 months!

How old do you have to be to collect disability in Alabama?

Alabama Disability Benefits: What You Need to Know. Almost a million Alabama residents are 50-64 years old — the perfect age to collect Social Security Disability Insurance (SSDI) benefits. That’s nearly 20% of the state’s population! However, just 4.6% qualified for Alabama disability through the SSDI program in 2018.

How long does it take to appeal a disability claim in Alabama?

If that happens, you have 60 days to appeal your denial in writing. Reconsideration, the first appeal step, takes about 100 days to finish. Only 2% of claimants get Alabama disability benefits after reconsideration. If you have to appeal a second time, you’ll schedule an Administrative Law Judge (ALJ) hearing.

What happens if you can't pass one medical exam?

So, if you can’t pass one program’s medical exam, the other won’t approve you, either. You must submit convincing medical evidence to support your SSI claim for Alabama disability. If you wait to apply until after your 65th birthday, age alone helps you meet these medical requirements. 2.

How often do you have to update your SSI?

The SSI program also provides a Cost-of-Living-Adjustment (COLA) increase in certain years. If you’re younger than 65, you’ll need to pass SSI disability updates every 3-7 years to keep your payments. But once that birthday passes, you’ll never have to worry about passing that SSI requirement again. As long as you meet the program’s financial eligibility requirements, you can keep your SSI payments for life.

How long do you have to wait to receive medicare if you have SSDI?

For more information on calculating how this is calculated, see our article on when you'll receive Medicare benefits. There is no waiting period for SSI recipients to receive Medicaid.

Which states have a lower income limit for Medicaid?

There are a few states, including Illinois and Ohio, that are exceptions to this rule. These states may have a lower income or asset limit for the Medicaid program than the SSI program, so they make their own Medicaid determinations.

Do you get medicaid if you are approved for SSI?

Do you get Medicare coverage if you were approved for SSI? Claimants who are approved for SSI only typically receive Medicaid coverage in most states. And like SSI, Medicaid is subject to income and asset limitations. Medicaid is a needs-based, state- and county-administered program that provides for a number of doctor visits and prescriptions each month, as well as nursing home care under certain conditions.#N#Can you ever get Medicare if you get SSI? Medicare coverage for SSI recipients does not occur until an individual reaches the age of 65 if they were only entitled to receive monthly SSI disability benefits. At the age of 65, these individuals are able to file an "uninsured Medicare claim," which saves the state they reside in the cost of Medicaid coverage. Basically, the state pays the medical premiums for an uninsured individual to be in Medicare so that their costs in health coverage provided through Medicaid goes down.

Do you get medicaid if you are on SSDI?

If you're approved for disability benefits, you'll also get Medicare or Medicaid, depending on whether you receive SSDI or SSI benefits. Disabled people who are approved for Social Security disability insurance (SSDI) benefits will receive Medicare, and those who are approved for Supplemental Security Income (SSI) will receive Medicaid.

Can I get concurrent disability from both SSI and SSDI?

Some disability recipients will be approved for concurrent benefits; that is, they will draw disability money from both SSDI and SSI. In such instances, the issue of whether a claimant will get Medicare or Medicaid is not so cut and dry. Claimants who are approved for concurrent disability benefits should consult their local Social Security office ...

How many states have Medicaid eligibility criteria?

Eleven states have elected to use eligibility criteria for Medicaid that are more restrictive than SSI's. In most of those states, SSI recipients will find that the rules about income and resources or the definition of disability are more restrictive for Medicaid than they are for SSI. Still, the federal government has imposed rules ...

Which states make their own Medicaid eligibility decisions?

A few states make their own Medicaid eligibility decisions using the same income, resource, and disability criteria that Social Security uses for the SSI program. Alaska, Idaho, Kansas, Nebraska, Nevada, Oregon, Utah, and the Northern Mariana Islands all make their own Medicaid eligibility decisions using SSI criteria.

What is medicaid for low income?

Medicaid is a health insurance program for low-income individuals that is operated by the states according to guidelines established by the federal government. The federal government requires the states to offer Medicaid coverage to some groups of people and allows the states to cover certain additional groups. One group required to be covered by Medicaid is disabled individuals with low incomes. But states are allowed to have different eligibility requirements than the SSI disability program. Whether SSI recipients are automatically eligible for and enrolled in Medicaid depends on the state that the recipient lives in.

Why is Indiana a 209b state?

Social Security calls these ten states the "209 (b) states" because it was section 209 (b) of the Social Security Amendments of 1972 that gave states the option of using their own criteria for Medicaid. Note that Indiana ceased being a 209 (b) state in 2014.

Does Medicaid automatically grant SSI?

Where Medicaid Eligibility Is Automatic. Most states automatically grant Medicaid when you get approved for SSI based on disability. In fact, most states let the Social Security Administration handle Medicaid enrollment for SSI recipients when they are approved for SSI.

What age can I get SSI?

You may be eligible for SSI if you are: Over age 65, blind, or disabled. “Blind” is defined as “central visual acuity for distance of 20/200 or less in your better eye with use of a correcting lens” or “visual field limitation in your better eye…”.

What is the difference between SSDI and SSI?

The main difference between the two is that SSI is need-based and does not take work history into account, while SSDI candidates have earned “work credits” by working for a certain number of years and contributing to Social Security taxes.

What is extra help for Medicare?

The Extra Help program provides savings on Medicare prescription drug coverage. Click here to read more about Medicare Extra Help. Start searching for Medicare Plans.

How do I apply for Social Security?

There are a few ways to apply. You can: Apply online through this SSI application link * . Call Social Security at 1-800-772-1213 (TTY 1-800-325-0778) and make an appointment. Visit your local Social Security office (expect a wait if you don’t have an appointment)

What is SSI funding?

SSI is a government program that is funded by “general tax revenues” as opposed to Social Security taxes. The program provides cash assistance for the purpose of paying for basic needs like food, clothing, and shelter. SSI is only for those who have little or no income/resources and are aged (over 65), blind, or disabled.

How much is the 2019 FBR for SSI?

This benefit is determined by the FBR, or Federal Benefit Rate. The 2019 FBR is $771 for single people and $1,157 for married couples. This amount is subject to change each year.

What does it mean to be disabled?

Disabled means that you have a physical or mental impairment which offers “severe functional limitations,” may result in death, and has lasted for at least one year. Living with limited income and resources. 2019 resources cannot exceed $2,000 for a child or individual adult and $3,000 for an adult couple.

How to apply for medicaid?

How to Apply. To apply for Medicare, contact your local Social Security Administration (SSA) office. To apply for Medicaid, contact your state’s Medicaid agency. Learn about the long-term care Medicaid application process. Prior to applying, one may wish to take a non-binding Medicaid eligibility test.

What is Medicare and Medicaid?

Differentiating Medicare and Medicaid. Persons who are eligible for both Medicare and Medicaid are called “dual eligibles”, or sometimes, Medicare-Medicaid enrollees. Since it can be easy to confuse the two terms, Medicare and Medicaid, it is important to differentiate between them. While Medicare is a federal health insurance program ...

How much does Medicare Part B cost?

For Medicare Part B (medical insurance), enrollees pay a monthly premium of $148.50 in addition to an annual deductible of $203. In order to enroll in a Medicare Advantage (MA) plan, one must be enrolled in Medicare Parts A and B. The monthly premium varies by plan, but is approximately $33 / month.

What is the income limit for Medicaid in 2021?

In most cases, as of 2021, the individual income limit for institutional Medicaid (nursing home Medicaid) and Home and Community Based Services (HCBS) via a Medicaid Waiver is $2,382 / month. The asset limit is generally $2,000 for a single applicant.

How old do you have to be to qualify for medicare?

Citizens or legal residents residing in the U.S. for a minimum of 5 years immediately preceding application for Medicare. Applicants must also be at least 65 years old. For persons who are disabled or have been diagnosed with end-stage renal disease or Lou Gehrig’s disease (amyotrophic lateral sclerosis), there is no age requirement. Eligibility for Medicare is not income based. Therefore, there are no income and asset limits.

Does Medicare cover out-of-pocket expenses?

Persons who are enrolled in both Medicaid and Medicare may receive greater healthcare coverage and have lower out-of-pocket costs. For Medicare covered expenses, such as medical and hospitalization, Medicare is always the first payer (primary payer). If Medicare does not cover the full cost, Medicaid (the secondary payer) will cover the remaining cost, given they are Medicaid covered expenses. Medicaid does cover some expenses that Medicare does not, such as personal care assistance in the home and community and long-term skilled nursing home care (Medicare limits nursing home care to 100 days). The one exception, as mentioned above, is that some Medicare Advantage plans cover the cost of some long term care services and supports. Medicaid, via Medicare Savings Programs, also helps to cover the costs of Medicare premiums, deductibles, and co-payments.

Does Medicaid cover nursing home care?

Medicaid also pays for nursing home care, and often limited personal care assistance in one’s home. While some states offer long-term care and supports in the home and community thorough their state Medicaid program, many states offer these supports via 1915 (c) Medicaid waivers.