How to Apply for Medicaid When You're on SSDI and Medicare

You may be able to get Medicaid even though you already have Medicare

If you receive SSDI and Medicare, you can also have Medicaid at the same time. The two programs work together—Medicare covers some costs, and Medicaid can cover what Medicare does not, including premiums, deductibles, and services Medicare does not pay for. You do not lose Medicare by adding Medicaid. The process for getting Medicaid is different from how you got Medicare, and it depends on which state you live in.

Medicaid is run by individual states, not by Social Security or Medicare. This means the rules, income limits, and how you explore all vary by location. Some states make it nearly automatic for SSDI recipients; others require you to submit a separate request. Knowing your state's rules is the first step.

Key Takeaways

Medicaid and Medicare can work together, and having both is common for people on SSDI.
Your state Medicaid office handles Medicaid, not Social Security—rules and income limits differ by state.
Some states automatically enroll SSDI recipients in Medicaid; others require you to request it yourself.
You will need proof of your SSDI status, income, and residency to complete a Medicaid request.
Contact your state Medicaid office or use your state's online portal to find out whether you may be covered and how to proceed.

Find your state Medicaid office and learn its rules

Start by contacting your state Medicaid office directly. You can find the phone number and website through the Centers for Medicare & Medicaid Services (CMS) website at medicaid.gov, which lists every state office. When you call, tell them you receive SSDI and Medicare and ask whether your state has automatic enrollment for SSDI recipients or whether you need to submit a request yourself.

Some states, called "Section 1619(b) states," automatically cover most SSDI recipients under Medicaid. Other states require you to meet additional income or resource limits. A few states have different rules altogether. Your state office can tell you in one call whether you may be covered and what documents you need to bring.

Many states also let you start the process online through their Medicaid portal. The portal usually asks for your name, Social Security number, income, and household size. If your state has an online option, the office staff can walk you through it over the phone.

Gather the documents you will need

Most states ask for the same basic documents. Have these ready before you contact your state office or log into the online portal: a copy of your Social Security card or a document showing your Social Security number, proof of your SSDI award (your award letter from Social Security works), and proof of your current address (a utility bill, lease, or bank statement dated within the last 60 days).

You will also need to report your current income. If you receive SSDI, that is your main income source, and your award letter shows the monthly amount. If you have other income—from work, a pension, or another source—write down the monthly amount. Some states also ask about resources (savings, investments, property), though SSDI recipients often have higher resource limits than other Medicaid applicants.

If you live with other people, you may need to report their income and relationship to you, depending on your state's rules. Ask your state office whether household income affects your Medicaid status.

Submit your request through your state's method

Once you know your state's process, you have three main options: explore online through your state's Medicaid portal, mail a paper process, or explore in person at your local Medicaid office. Online is usually fastest—many states process online requests within two to four weeks. Mailed applications often take longer because of mail delays and processing backlogs.

If you explore online, you will create an account, enter your information, and upload photos of your documents. Keep copies of everything you submit and note your process number. If you explore by mail, send your documents to the address your state office provides and request a receipt or tracking number.

Some states also let you explore by phone with a caseworker. This option is useful if you have questions while filling out the form or if you do not have reliable internet access. The caseworker can guide you through each question and tell you when ready if anything is missing.

Understand what happens after you submit

After you submit your request, your state office will review your information to see whether you meet the income and resource limits. For most SSDI recipients, income is not a barrier—your SSDI payment is usually low enough to may have access to. The main question is whether your state covers SSDI recipients at all and whether you meet any other requirements, such as age or disability status (which you already have).

Your state office will send you a notice by mail telling you whether you are covered. This notice usually arrives within 30 to 45 days, though it can be faster or slower depending on how busy the office is. The notice will also tell you your Medicaid number, when your coverage starts, and what services are covered in your state.

If your request is denied, the notice will explain why and tell you how to appeal. You have the right to ask for a hearing if you disagree with the decision. Your state office can explain the appeal process, or you can ask a local legal aid office for help.

Know what Medicaid covers alongside Medicare

Medicaid coverage varies by state, but it typically covers costs that Medicare does not. This includes your Medicare Part B premium (usually around $165 per month, though it changes yearly), your Medicare Part A deductible (the amount you pay before Medicare starts paying), and your Part B deductible. Medicaid also often covers prescription drugs, dental care, vision care, and hearing aids—services Medicare does not pay for.

Some states offer extra coverage for people on both Medicare and Medicaid, called "dual may be able to access" programs. These programs may cover additional services or lower your out-of-pocket costs further. When your Medicaid coverage is approved, your state office will send you information about what is covered and how to use your benefits.

You will have both a Medicare card and a Medicaid card. When you see a doctor or go to a pharmacy, show both cards. The provider will bill Medicare first, then send the remaining bill to Medicaid.

Renew your Medicaid coverage when required

Medicaid coverage does not last forever. Your state will ask you to renew your coverage periodically—usually once a year, though some states renew every two or three years. Your state office will send you a renewal notice by mail with instructions on how to renew. You can usually renew online, by mail, or by phone using the same method you used to explore.

Renewal is simpler than the first process because your state already has most of your information. You mainly need to confirm that your income and household have not changed. If something has changed—you moved, your income went up or down, or someone moved in or out—report it on the renewal form.

If you do not renew by the important date, your Medicaid coverage will end. Your state office will send you a reminder notice before the important date, so watch your mail. If you miss the important date, you can usually reapply, but there may be a gap in coverage.

Frequently Asked Questions

Will getting Medicaid affect my SSDI or Medicare?

No. Medicaid is a separate program and does not change your SSDI payment or your Medicare coverage. You can have all three at the same time. Medicaid straightforward fills in gaps that Medicare does not cover.

What if my state says I do not meet the income limit?

Some states have income limits that are lower than the SSDI payment amount. If your state denies you, ask whether you can appeal or whether your state has a waiting list program. A few states let SSDI recipients stay on Medicaid even if their income is slightly over the limit, under a rule called "Section 1619(b)." Your state office can explain your options.

How long does it take to get Medicaid after I explore?

Most states process applications within 30 to 45 days. Online applications are often faster than mailed ones. Your state office can tell you how long it typically takes in your area and whether you can check the status of your process online.

Do I need to report changes in my income or living situation?

Yes. If your income changes, you move, or your household size changes, report it to your state Medicaid office. Some changes may affect your coverage. Your state office will tell you which changes you must report and how to report them.

Can I have Medicaid in one state if I move?

No. Medicaid is state-based, so if you move to a different state, you will need to explore for Medicaid in your new state. Contact your new state's Medicaid office as soon as you move. There may be a gap in coverage while you wait for approval in the new state, so explore quickly.

This guide is for general information only and is not medical, financial, legal, or other professional advice. For decisions specific to your situation, consult a qualified professional. See our Editorial Policy.