Knowledge about disability benefits and health care visits – Michigan Disability Lawyers

People with disabilities present unique challenges, and one of the most pressing concerns many face is how to access affordable healthcare. Fortunately, specific programs are designed to support people with disabilities including Social Security Disability Insurance (SSDI), Supplementary Safety Income (SSI), Medicare and Medicaid. Among the Disability Attorneys in Michigan, we understand the complexity of navigating these programs, and we are here to help guide you through the process.

Qualify for SSDI benefits

Social Security Disability Insurance (SSDI) is a federal program that provides monthly benefits to individuals who are unable to work due to disability. Unlike SSIs based on financial needs, SSDI is based on your work history and the amount you pay to the Social Security system via FICA or payroll tax. To qualify for SSDI, the following criteria must be met:

Work Credits: You must have worked for a certain period of time and paid Social Security to earn work credits. The number of credits required depends on your age when you are disabled, but generally you need 40 credits, of which 20 years have earned 20 credits over the last 10 years.

Medical conditions: Your disability must meet the Social Security Agency’s (SSA) definition of disability. It must stop you from doing a lot of work and is expected to last for at least 12 months or result in death.

If you meet these criteria, you may be eligible for SSDI benefits. Once you are eligible, you can also access medical insurance through Medicare.

SSDI and Medicare: Healthcare Lifeline

When you are eligible for SSDI, you will automatically qualify for Medicare after waiting for 24 months. Medicare is a federal health insurance plan for individuals aged 65 or older. However, people under the age of 65 who have a specific disability, permanent renal failure, or amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig's disease, may also be eligible for Medicare. The program helps health care costs, but cannot cover all medical expenses or the costs of most long-term care.

Once you are eligible for Medicare, the Social Security Agency (SSA) automatically incorporates you into the original Medicare, which includes A (Hospital Insurance) and Part B (Medicare). Here is what each section covers:

1. Medicare Part A Help cover hospital inpatient care, including critical visits to hospitals and skilled nursing facilities (but not custody or long-term care). Part A also covers some home care, hospice and inpatient care in religious non-health care facilities.
2. Medical Insurance Part b Help cover medically necessary medical services, outpatient care, home health services, durable medical equipment, mental health services, limited outpatient prescription medications, and many preventive services.

Medicare doesn't cover everything, so you can consider other options to help pay for additional medical expenses. If you choose to own the original Medicare, you can purchase a Medicare supplementary insurance (MEDIGAP) policy from a private insurer. Medigap helps pay for some of the expenses Medicare doesn't have, such as copayment, co-insurance and deductibles.

Additionally, you can choose the Medicare Advantage plan, a bundling option that private insurers usually offer. The Medicare Advantage program typically includes Part A, Part B, and usually Part D (prescription drug coverage), simplifying the process and potentially reducing out-of-pocket costs.

Medicare aims to help reduce the financial burden of health care for people with disabilities. Nevertheless, it is necessary to understand the various parts of Medicare and related costs, including premiums, deductibles and co-payments.

Eligible for SSI

Supplementary Safe Income (SSI) is a demand-based program that provides financial assistance to persons with disabilities with limited income and resources. Unlike SSDI, SSI has no requirements for a job history; qualifications are based on your financial status and inability to work. To qualify for SSI, you must meet the following main requirements:

Disability: You must have a qualified disability defined by the Social Security Bureau. This includes both physical and mental disorders, which greatly limits your ability to perform basic work-related activities.

Income and Resources: Your income and resources must be kept below a certain threshold. SSA considers your income sources, including income, pensions, and other benefits. Resources include assets such as bank accounts, land you do not live in, and savings. In 2025, SSI's resource limit is $2,000 for individuals and $3,000 for couples.

Country of Citizenship: You must be a U.S. citizen or a qualified non-citizen.

If you are eligible for SSI, you will receive monthly payments to cover basic living expenses, including food, clothing and shelter. Additionally, SSI recipients are usually eligible for Medicaid.

SSI and Medicaid: Health coverage for low-income disabled people

If you are eligible for SSI, you may automatically obtain Medicaid, a state and federal program that provides health coverage for low-income individuals, including those with disabilities. Unlike Medicare, which is used by individuals who are eligible for SSDI, Medicaid is designed for people with limited income and resources, including those who receive SSI benefits.

Medicaid provides comprehensive medical services including:

Hospitals and doctors visit: Cover most expenses related to medical visits, inpatient and outpatient services.

prescription: Covered prescription medications.

Professional Nursing: Medicaid also covers long-term care, including nursing home care and family and community services.

Each state manages its own Medicaid program, so the benefits and eligibility requirements may vary. However, if you receive an SSI benefit, you may be eligible for Medicaid and will usually simplify the application process.

We help ensure the benefits and concerns you may be entitled to

Navigating disability healthcare can be complex, but understanding available programs, such as SSDI, SSI, Medicare, and Medicaid, is the first step to ensuring the support you need. Among the disability lawyers in Michigan, we help people with disabilities get the benefits they deserve. If you have questions about eligibility or need help in your application or file a lawsuit against a denial, please contact personalized guidance.

Contact us now by submitting the form online or calling 800-949-2900 for a free case assessment.