Abromson & Carey, Attorneys at Law
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What effects do SSI benefits have on Medicaid and Medicare?


For many people in New Jersey, the supplemental security income they receive as part of the Social Security Administration's program is crucial for everyday expenses. However, not many people know the availing SSI benefits can have its effects on other federal government benefits and programs such as Medicaid, Medicare and state programs that cover Medicare costs. Since the effects can sometimes be quite significant, it is important for an SSI beneficiary to understand how it happens.

According to existing rules, an SSI beneficiary automatically qualifies for Medicaid in most states, including New Jersey. That is because an application for SSI benefits is also a petition for Medicaid. While SSI and Medicaid are linked to each other in most states, Medicare is linked to social security disability benefits. However, it is possible for a person to obtain both Medicaid and Medicare. Further, if a person is eligible for SSI and has Medicare, the person may also seek additional help through the Medicare Prescription Drug Coverage program.

In addition to the federal programs, there exists state programs that assist in covering Medicare costs. The person becomes eligible if the person already receives federal Medicare and has limited income -- the limits, however, vary from state to state. The programs that a person can apply for are:

  • The Qualified Medicare Beneficiary Program, which helps by paying premiums along with deductibles and coinsurance for low-income Medicare beneficiaries
  • Qualified Disabled Working Individual, which helps Medicare beneficiaries by paying their Medicare Part-A premiums, albeit under certain conditions
  • Specified Low-Income Medicare Beneficiary Program or Qualifying Individual Program, which pays for Part-B premiums of a Medicare beneficiary, albeit under certain conditions

As is evident from the nature of these federal and state programs, SSI benefits for disabling conditions often require an in-depth understanding of federal and state guidelines. Sadly, this can become a significant challenge for those people who have had limited knowledge and are applying for the first time.

Similarly, an appeal resulting from a denial of SSI benefits can also be difficult to handle. Considering that, an SSI applicant or appellant may consider speaking with an experienced attorney who can educate, advise and guide them through the process.

Source: Social Security Administration, "Understanding Supplemental Security Income SSI and Other Government Programs -- 2014 Edition," Accessed on Nov. 7, 2014

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