How Medicaid Works When You Receive Social Security Disability

Medicaid may be able to access when you receive SSDI

If you receive Social Security Disability Insurance (SSDI), you may be covered by Medicaid automatically in your state, or you may need to meet separate income and asset limits. The connection between SSDI and Medicaid is not the same everywhere — it depends on which state you live in and when you became disabled.

Most states use one of two systems. In Section 1619(b) states, you stay on Medicaid as long as you meet the original disability standard, even if your earnings later exceed the SSDI payment amount. In regular Medicaid states, your Medicaid coverage ends when your SSDI payment plus other income exceeds that state's limit. A third group of states, called 1634 states, automatically enroll you in Medicaid when you start SSDI, with no separate process.

The fastest way to know your state's rules is to call your state Medicaid office directly — they can tell you in one call whether you are already covered, what you need to do to stay covered, and what the income or asset limits are for your household.

Key Takeaways

Some states automatically enroll you in Medicaid when you start SSDI; others require you to meet separate income and asset limits to keep coverage.
Your state Medicaid office, not Social Security, determines whether you stay on Medicaid once your SSDI begins.
If you work while on SSDI, your earnings may affect your Medicaid coverage depending on your state's rules and whether you live in a Section 1619(b) state.
You must report changes in income, household size, or living situation to your state Medicaid office to keep your coverage active.
If Medicaid ends, you may be able to buy coverage through the health insurance marketplace or through your employer if you return to work.

Automatic Medicaid enrollment when you start SSDI

In 1634 states, you are automatically enrolled in Medicaid the same month your SSDI payments begin. You do not need to file a separate Medicaid process. These states are: Connecticut, Delaware, Florida, Georgia, Hawaii, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.

If you live in one of these states, you will receive a Medicaid card in the mail within one to two months of your SSDI approval. You do not need to do anything to receive it. If you do not receive a card within that timeframe, contact your state Medicaid office to confirm your enrollment.

Medicaid income and asset limits in regular Medicaid states

In states that are not 1634 states, you must meet your state's Medicaid income limit to keep coverage. The limit is usually based on your household's total monthly income — SSDI payment plus any other income your household receives. Each state sets its own limit; there is no single federal number. Some states use 74 percent of the federal poverty level, others use 100 percent, and a few use higher amounts.

Your state Medicaid office will tell you the exact income limit when you contact them. They will also tell you whether your household has an asset limit — some states count savings, vehicles, or property; others do not. If your income or assets exceed the limit, you lose Medicaid coverage, even though you remain on SSDI.

You must report any change in income to your state Medicaid office within 10 days. This includes a raise at work, a new job, a roommate moving in, or a change in household size. Failure to report can result in overpayment notices or loss of coverage without warning.

How work affects your Medicaid coverage

If you work while receiving SSDI, your earnings may cause you to lose Medicaid in a regular Medicaid state. However, Section 1619(b) states allow you to keep Medicaid even when your work earnings push your total income above the SSDI payment amount — as long as you still meet the medical disability standard and your earnings do not exceed a higher threshold set by your state.

The Section 1619(b) states are: Alabama, Alaska, Arizona, Arkansas, California, Colorado, District of Columbia, Idaho, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Nevada, New Hampshire, New Mexico, New York, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.

If you live in a Section 1619(b) state and you begin working, contact your state Medicaid office before you start. They will explain the earnings threshold and what you must report each month. If you live in a regular Medicaid state, your Medicaid will end when your income exceeds the limit, but you may be able to buy coverage through the health insurance marketplace or through your employer's plan.

Medicaid coverage if you work and earn too much

If your SSDI payment plus work earnings exceed your state's Medicaid income limit, your coverage will end. The timing depends on your state — some end it the month after you report the overage, others end it at the end of the month in which you report it. Your state Medicaid office will send you a notice before coverage ends, usually 10 to 30 days in advance.

When Medicaid ends, you have several options. You can buy a plan through the health insurance marketplace at healthcare.gov during the open enrollment period (November 1 to January 15 each year) or within 60 days of losing Medicaid coverage. You may also be able to enroll in your employer's health plan if you work enough hours to may have access to. If you have a spouse or children on Medicaid, report the change to your state Medicaid office — their coverage may continue even if yours ends.

Reporting changes to keep Medicaid active

You must report changes to your state Medicaid office to keep your coverage. The most common changes are: a new job or raise, a household member moving in or out, a change in marital status, a new child, or a change in your living situation. You must report within 10 days of the change.

Your state Medicaid office will tell you how to report — by phone, mail, online portal, or in person. Some states use a single online portal for all benefits; others have separate systems for Medicaid. If you are unsure how to report, call your state Medicaid office and ask. Failing to report can result in loss of coverage or a bill for services you received while ineligible.

Keep copies of any documents you send — pay stubs, lease agreements, birth certificates, or letters from your employer. If your state later questions your coverage, these documents prove you reported the change on time.

What to do if your Medicaid ends

If your Medicaid coverage ends because your income is too high, you have 60 days to enroll in a marketplace plan without penalty. Go to healthcare.gov, enter your zip code, and select plans available in your area. You will see the monthly premium and what you pay at the doctor's office. Some plans may be free or low-cost depending on your income.

If you lose Medicaid for a reason other than income — for example, you move out of state or fail to report a change — you may still have 60 days to enroll in a marketplace plan. Contact your state Medicaid office to ask why your coverage ended and whether you have a special enrollment period.

If you cannot afford a marketplace plan, look into whether you may have access to for other programs. Some states offer programs for people with disabilities who earn too much for Medicaid. Your state Medicaid office can tell you whether such a program exists in your state.

Frequently Asked Questions

Do I automatically get Medicaid when I start SSDI?

It depends on your state. If you live in a 1634 state, yes — you are automatically enrolled. If you live in another state, you must meet that state's separate income and asset limits. Call your state Medicaid office to find out which rule applies to you.

What happens to my Medicaid if I go back to work and earn too much?

In Section 1619(b) states, you keep Medicaid as long as you still meet the disability standard, even if your earnings are high. In other states, Medicaid ends when your income exceeds the limit. You then have 60 days to enroll in a marketplace plan. Contact your state Medicaid office before you start work to learn your state's rules.

Can I keep Medicaid if I move to a different state?

No. Medicaid is state-run, so you must reapply in your new state. Contact your new state's Medicaid office within 30 days of moving. Your coverage in your old state will end, and your new state will determine whether you are covered based on its own rules and income limits.

What if I do not report a change in income?

Your state Medicaid office may discover the unreported income during a review or when you use your Medicaid card. If you were ineligible, you may receive a bill for services you received while not covered, or your coverage may be terminated. Always report changes within 10 days to avoid this.

How do I find my state Medicaid office?

Go to medicaid.gov and select your state from the map. The site will give you the phone number and website for your state Medicaid office. You can also call 211 and ask for your state Medicaid office — they will give you the correct number and may help you explore.

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.