Coverage Options For People With Disability

Submitted by pec on

People with disabilities often face challenges in accessing healthcare, and it is crucial for anyone with a disability to understand the different coverage options available. Knowing what your options are will help you make the best possible choice to ensure that you have access to healthcare. And understanding all of your options will help you make the most cost-effective choice so that you’re not struggling to pay for care that you need. Let’s look at the options available so you can decide which one is right for you.

Government Programs

Medicaid is a government health care program that was created to help children, low-income people, and people with disabilities afford healthcare. There are more than 10 million children and adults with disabilities who use Medicaid as their primary source of healthcare.

Adults who receive SSI automatically qualify for Medicaid coverage in most states. There are some states where you will need to sign up for Medicaid even though you are automatically eligible because you receive SSI.

And in a handful of states you will need to apply for Medicaid even if you receive SSI. Adults who receive Social Security disability may qualify for Medicaid after a 24-month waiting period.

Medicaid provides a full range of healthcare services for adults with disabilities, including preventative care from a primary care physician and emergency care.

Private Health Insurance

If you don’t want to get health insurance through Medicaid or don’t qualify for Medicaid you can choose private health insurance. If you’re still working but are disabled, you may still be able to get healthcare coverage from your employer-sponsored insurance. If you choose this coverage there are certain obligations that healthcare providers must meet that are specified in the Americans With Disabilities Act.

For example, any healthcare provider that is part of an employee-sponsored healthcare plan must have facilities that are accessible to all people regardless of their disability. If you choose to buy private insurance through the healthcare marketplace those providers also must adhere to the regulations in the Americans With Disabilities Act.

Buying private insurance through the healthcare exchange can be an affordable way to get private insurance. You should qualify for healthcare subsidies that can reduce the cost of private health insurance if you would rather choose private insurance over Medicaid.

If you have disability insurance as part of your work benefits package that insurance will pay you money while you are considered disabled. That money can help offset the cost of private health insurance if you must buy private insurance.

Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI)

SSI and SSDI are government benefit programs that provide cash payments to people who are not able to work. That money can be used for rent or mortgage, food, living expenses, and healthcare expenses.

SSI is a program that was created specifically for low-income people, or disabled people who have never worked. Many children that have disabilities receive SSI that is paid to their parents to help pay for their living expenses. Then, when the child turns 18, they can apply for SSI that is paid directly to them.

If you receive SSI, you will automatically qualify for Medicaid health insurance in almost every state. You may also qualify for Medicare.


Social Security disability benefits work a little differently. SSDI covers adults who have worked in the past but have to stop working because of a disability or illness. Anyone who works and has earned work credits can apply for SSDI. But, in order to have that application approved you have to prove to the Social Security Administration that you have a condition that makes it impossible for you to work and that the condition will least 12 months.

If you are approved for SSDI you may qualify for Medicaid after a 24 month waiting period. During that waiting period you may be able to stay on your employer-sponsored insurance. Or, you may be able to stay on state-subsidized insurance. You can also buy private insurance through the ACA marketplace.

Other Coverage Options

There are also state-specific health care options in most states. The CDC current has a pilot program that works with state schools and health care systems to provide health care in these states:

  • Georgia State University Foundation Inc.
  • Massachusetts Department of Public Health
  • Michigan Department of Health and Human Services
  • The Curators of the University of Missouri on behalf of UM-Kansas City
  • Montana Department of Public Health and Human Services
  • University System of New Hampshire
  • Health Research Inc./New York State
  • Ohio State University
  • Oregon Health and Science University
  • Utah Department of Health

Your state may have state-specific options for health care or other services that you are eligible for if you receive any kind of disability benefits.

There are also national non-profit groups that provide a wide range of services for people with disabilities including help accessing mental health services and health care. Some of the best organizations that serve people with disabilities are:

  • Easterseals
  • Special Olympics
  • Friends of Disabled Adults and Children
  • United Cerebral Palsy
  • The Arc
  • National Alliance on Mental Illness
  • Goodwill Industries International
  • STAR Institute
  • National Center for Learning Disabilities

These organizations accept applications for assistance on a rolling basis so you can apply at any time.

Speak With a Disability Lawyer

There is a lot of information to try and understand when it comes to disability benefits and how they impact your healthcare and living expenses. If you have more questions about disability benefits, applying for disability benefits, or the disability benefit approval process you should speak with a disability lawyer.

A disability attorney can help you understand what your specific options are so you can decide what option is the best for you. A disability attorney can also help you apply for disability benefits.

Fill out the free case evaluation to get connected with an independent social security attorney who subscribes to the website and may be able to answer questions you have about coverage options for people with disabilities.