What Happens to Medicaid When You Switch from SSI to SSDI?

 In Social Security, Special Needs Planning


I have two disabled brothers who are 36 and 27 years old. They live with my mom at home who recently retired and started to receive Social Security. As a result, my brothers switched from receiving Supplemental Security Income to Social Security Disability Income and from Medicaid to Medicare. Now life sustaining supplies are being denied to them. I really want them switched back to Medicaid. We never had a problem and had a case manager who helped us. Now with Medicare it is all on me.
Photo by Nathan Anderson on Unsplash


This may depend on your state, but I see no reason that your brothers can’t receive both Medicaid and Medicare.

As your family has experienced, quite often, individuals who were disabled before age 22 can switch from Supplemental Security Income (SSI) to Social Security Disability Income (SSDI) when a parent retires or dies. This is generally a good change because the SSDI benefits, which are based on the parent’s work record, often are higher than SSI benefits. In addition, this relieves the disabled individual from having to maintain financial eligibility for SSI, which can be, in layman terms, a total pain in the neck. 

As your family has also experienced, SSI is linked to Medicaid and SSDI is linked to Medicare. Your brothers were automatically enrolled in Medicaid as a result of their receiving SSI, and Medicaid as you have also experienced, provides much broader coverage than Medicare. When your brothers were switched from SSI to SSDI, Medicaid eligibility was no longer automatic. But there’s no reason that I’m aware of that they can’t apply separately for Medicaid. Any of the social service agencies that provide assistance to your brothers should be able to help with this.


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How Will Child Support Affect My Son’s SSI?

How Does My Daughter Switch Over from SSI to SSDI, and Maintain her Medicaid?

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The (d)(4)(A) Trust Safe Harbor for Medicaid and SSI

Showing 4 comments
  • David

    My brother currently has NJ Family Care Medicaid and was recently awarded SSDI which will also give him Medicare. For my brother he needs to keep his Medicaid because of his DDD services. That being said, is SSDI considered income in relation to the $1468.00 threshold in NJ for a single person and this means that if he is receiving approximately $1,200.00 in SSDI that he will now not be able to work as no company will hire him for such limited hours as not to reach the threshold of $1468.00. Or is the SSDI considered separate and not part of the $1468.00 threshold and he can continue to work?

    • Harry Margolis

      You’ll have to check with the Medicaid agency in New Jersey to be certain, but my guess is the SSDI will be treated as income, limiting your brother’s ability to work.

  • Michelle R McGee

    I live in New Mexico; in New Mexico if you only receive SSDI and not SSI you are not eligible for Medicaid only Medicare. My husband and I are only $100 over the income level for me to receive SSI. So now I can only get help paying for my Medicare premium; my husband who receives VA disability is eligible for Medicaid however.

    • Harry Margolis

      Your situation highlights one of the many problems with our health insurance system, the draconian cut off of benefits based on income. We should have universal health insurance coverage for everyone. Until we have that, I recommend that you look into the Affordable Care Act, also known as Obama Care. The Biden administration has extended the sign-up window, so you could apply now. My guess is that you would be eligible for a substantial subsidy.
      Good luck.

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