Consumer Guide to Health Care
Medicare and Medicaid for those with Disabilities
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Medicare if you have a disability and are under 65
If you are under 65 and have a disability you
may qualify for Medicare. You will usually need to
receive Social Security Disability Income (SSDI) for 24
months before becoming eligible for Medicare.
Exceptions are made for those with end stage renal
disease or Amyotrophic Lateral Sclerosis (ALS), also
known as Lou Gehrig’s Disease. To qualify for
SSDI you must meet the standards
for disability set by the Social Security
Administration and you or your spouse must have paid
Social Security taxes while employed.
Security Protection If You Become Disabled from the
Social Security Administration can help you determine
whether or not you are eligible for Social Security
Disability Income (SSDI).
If you qualify for Medicare our Medicare
information page may be of interest to you.
Medicaid if you have a disability or a child with a disability
Supplemental Security Income (SSI)
disability benefits are for adults or children who have a
disability and meet income, resource and living
arrangement requirements. Although the standards for
determining if you have a disability are the same as for
Social Security Disability Income (SSDI), you do not
have to have paid Social Security taxes to qualify for
SSI. Once you qualify for SSI, you are also
eligible for Medicaid.
Supplemental Security Income: Additional information
from the Wisconsin Department of Health Services, including information on qualifying for
Supplemental Security Income.
Purchase Plan offers people with disabilities who
are working or interested in working the opportunity to
buy health care coverage through the Wisconsin Medicaid
Program. Depending on an individual’s income, a
premium payment may be required for this health care
coverage. This information is also available in
Katie Beckett Program allows certain children with long-term disabilities or complex
medical needs, living at home with their families, to
obtain a Wisconsin Medicaid card. Children who are not
eligible for other Medicaid programs because the income
or assets of their parents are too high may be eligible
for Medicaid through the Katie Beckett Program.
Additional information about Medicaid
If you have further questions about your eligibility for
SSDI or SSI or if you want to apply for Medicare, call
the Social Security Administration. The toll-free
telephone number is: 1-800-772-1213. The TTY-TDD number
for the hearing and speech impaired is 1-800-325-0778.
Medicare and Medicaid, 2005: A Resource Guide for People
with Disabilities, Their Families and Advocates: This guide from the
Kaiser Family Foundation
provides information on eligibility, benefits, and appeal
rights as well as information on interaction between
Medicare and Medicaid for those who are eligible for both
Medicare and Medicaid When You Work, 2005: A Resource
Guide for People with Disabilities, Their Families, and
Their Advocates: Also from the Kaiser Family Foundation,
this guide explains what happens to your income and health benefits
if you have a disability and would like to return to work.
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April 26, 2013