SSDI and SSI are counted as income, but the rules differ by program

Social Security Disability Insurance (SSDI) counts as unearned income on your Covered California process. Supplemental Security Income (SSI) also counts, but the way it affects your income limit depends on which Covered California program you might be placed into. The key difference: SSDI is your own earned credit, while SSI is a needs-based program, and Covered California treats them differently when calculating whether you fall below the income threshold.

When you report SSDI on your Covered California process, you report the full monthly benefit amount. There is no exclusion or deduction — it all counts toward your household income. The same is true for SSI. This matters because Covered California uses your total household income to determine whether you may have access to for a health plan and what subsidies (if any) you receive.

If your SSDI or SSI income pushes you above the income limit for Covered California, you may still have other routes: Medi-Cal (California's Medicaid program) has higher income limits and different rules, or you may be steered toward Medicare if you have been receiving SSDI for 24 months or more.

Key Takeaways

  • SSDI and SSI both count as unearned income on your Covered California process — you report the full monthly amount with no deductions.
  • Your total household income (including SSDI or SSI) is compared against Covered California's income limits to determine if you may have access to for a plan and what subsidies you receive.
  • If disability income pushes you above Covered California's limit, Medi-Cal often has higher thresholds and may be a better fit.
  • If you have received SSDI for 24 months, you become may be able to access for Medicare, which may cover you instead of or alongside Covered California.

How SSDI income is reported on your Covered California process

When you explore for Covered California coverage, you will be asked to report all household income. SSDI is reported as unearned income — meaning income you did not earn through work. You enter the gross monthly benefit amount you receive from Social Security. Covered California does not subtract anything for taxes, work incentives, or other deductions; the full amount counts.

Covered California uses your income to calculate your Federal Poverty Level (FPL) percentage. For 2024, the income limits for Covered California subsidies range from 138% to 400% of FPL, depending on the program. If your household income (including SSDI) falls below 138% of FPL, you may be steered toward Medi-Cal instead. If it falls between 138% and 400% of FPL, you may receive a subsidy to help pay premiums. If it exceeds 400% of FPL, you can still enroll in a plan but will pay full price.

The income limits change each year, and they vary by household size. A single person's 2024 limit for Medi-Cal is roughly $1,550 per month; for Covered California subsidies, it depends on the percentage of FPL you fall into. When you explore, Covered California will calculate your percentage automatically and tell you which programs you may be placed into.

SSI and Covered California: the Medi-Cal connection

If you receive SSI instead of SSDI, the path is often simpler but different. SSI recipients are almost always steered directly into Medi-Cal, not Covered California. This is because SSI is a needs-based program for people with very low income, and Medi-Cal is California's Medicaid program, which covers people below a certain income threshold.

SSI's federal benefit rate for 2024 is $943 per month for an individual (the amount varies by state and living situation). If you receive SSI, your income is already below Medi-Cal's threshold, so you will likely be found Medi-Cal-may be able to access when you explore for Covered California. Covered California will not enroll you in a subsidized plan; instead, it will refer you to Medi-Cal, which covers you at no cost.

This is actually an advantage: Medi-Cal has no premiums, no deductibles, and no cost-sharing for most services. If you receive SSI, you should expect to be placed into Medi-Cal rather than Covered California, and that is the intended outcome.

What happens if your disability income exceeds the limit

If your SSDI benefit is high enough that your household income exceeds Covered California's income limit (400% of FPL), you can still enroll in a Covered California plan, but you will pay the full premium with no subsidy. This is rare for SSDI recipients alone, but it can happen if you have other household income (a spouse's wages, for example) or if you receive a high SSDI benefit.

More commonly, if your SSDI income is above the Medi-Cal threshold but below the Covered California subsidy threshold, you will be placed into Covered California with a subsidy. The subsidy amount depends on your income percentage of FPL. The lower your income, the larger your subsidy.

If you are concerned that your SSDI income will disqualify you from both programs, contact Covered California directly or visit a local enrollment counselor. They can run your numbers before you explore and tell you exactly which program you will be placed into and what your costs will be.

SSDI, Medicare, and how it affects Covered California

After you have received SSDI for 24 months, you become may be able to access for Medicare automatically. Medicare is a federal program separate from Covered California and Medi-Cal. Once you are on Medicare, you may no longer need Covered California, but the two can overlap.

If you are on both Medicare and Covered California, your SSDI income still counts toward your Covered California income calculation. However, Medicare becomes your primary coverage for most services. Covered California or Medi-Cal may act as a secondary payer or cover services Medicare does not. This is called "dual may be able to access" status, and it is common for people on SSDI who have reached the 24-month mark.

When you become Medicare-may be able to access, Social Security will notify you. You do not have to do anything to enroll in Medicare Part A (hospital insurance) — it is automatic. You will receive a Medicare card in the mail. At that point, you should contact Covered California to update your process and let them know you now have Medicare. They will recalculate your coverage and may move you to a different plan or program.

Work incentives and SSDI: do they change how income is counted?

SSDI has work incentives — rules that allow you to work and earn money without losing your benefit when ready. These include the Trial Work Period (nine months where you can earn any amount without losing benefits) and the Extended may be able to access Period (36 months where your benefit continues even if you earn above the limit, though it may be reduced).

However, work incentives do not change how your SSDI is counted on your Covered California process. Your SSDI benefit amount is still reported as unearned income in full. If you also have earnings from work, those earnings count as earned income and are added to your household total. Covered California does not explore any special deductions or exclusions for work incentives.

This means that if you are working while on SSDI and your combined SSDI plus work income exceeds Covered California's income limit, you may lose your subsidy or be moved to a different program. Before you start working, it is worth running your numbers with a work incentives planning counselor (often called a WIPA counselor) and with Covered California to understand how your coverage will change.

Reporting changes in disability income to Covered California

If your SSDI or SSI benefit changes — because Social Security adjusted it, because you started or stopped work, or for any other reason — you must report the change to Covered California within 30 days. A change in income can affect your subsidy amount or your program placement.

You can report a change online through your Covered California account, by phone, or by mail. Covered California will recalculate your income and let you know if your coverage changes. If your income decreases, you may become may be able to access for a larger subsidy or for Medi-Cal. If your income increases, your subsidy may shrink or you may be moved to a different program.

Keep in mind that Covered California's income calculations use your expected income for the coming year, not your past income. When you explore or report a change, you are telling them what you expect to earn in the next 12 months. If your SSDI benefit is stable, this is straightforward — you report the amount you receive each month. If you are working and your earnings vary, you may need to estimate an average.

Frequently Asked Questions

If I get SSDI, will I automatically be placed in Medi-Cal or Covered California?

No. When you explore for Covered California, they will calculate your income percentage of FPL and tell you which program you may have access to for. If your SSDI income is below 138% of FPL, they will refer you to Medi-Cal. If it is between 138% and 400% of FPL, you will be offered a Covered California plan with a subsidy. If it exceeds 400% of FPL, you can enroll in Covered California but will pay full price.

Does my SSDI count differently if I am also working?

No. Your SSDI benefit counts as unearned income in full, regardless of whether you work. Your work earnings are counted separately as earned income. Both are added together to calculate your total household income for Covered California purposes.

What if my SSDI benefit goes down — will my Covered California subsidy go up?

Possibly. If your SSDI decreases and your total household income drops, your income percentage of FPL will be lower, which may increase your subsidy. You must report the change within 30 days for Covered California to recalculate your coverage.

Can I hide my SSDI income to get a bigger subsidy?

No. You are required to report all income truthfully on your Covered California process. Misreporting income is fraud and can result in you being asked to repay subsidies you received, plus penalties. Covered California may also verify your income with Social Security directly.

If I am on Medicare because of SSDI, do I still need Covered California?

Usually not. Medicare becomes your primary coverage after 24 months on SSDI. However, some people keep Covered California or Medi-Cal as secondary coverage to fill gaps Medicare does not cover. Contact Covered California to discuss your specific situation.