SSI-Related Medicaid

Is SSI-Related Medicaid Right for You?

Medicaid is government-funded health coverage for people in certain situations. You may qualify if you:

• Have low income, no matter how much you have in resources or whether you have a disability. Learn more about income-based Medicaid.
• Get Supplemental Security Income (SSI) benefits or qualify for SSI’s 1619(b) rule, which helps people who used to get SSI. In either case, you automatically get Medicaid coverage and don’t need to worry about the rules discussed here. Learn more in DB101’s SSI article.
• Have low income, low resources, and a disability. SSI-related Medicaid is explained on this page.
• Have a disability and work, even if your income is higher. Learn more about Freedom to Work.

Answer the questions on this page to see if you might qualify for SSI-related Medicaid. If so, it’s probably your best health coverage option because it doesn’t usually have a premium, the copayments for services are generally lower than copayments required by private plans, and Medicaid covers more services than most private plans. And, if you also have Medicare coverage, SSI-related Medicaid usually means you can qualify for a Medicare Savings Program that helps pay your Part B premium.

Also, if you qualify for Medicaid, you cannot get government help paying for an individual plan on HealthCare.gov.

Medicaid’s rules for immigrants:

• Undocumented immigrants do not qualify for full Medicaid coverage, but they may qualify for Medicaid coverage for emergency services.
• Most immigrants who have been lawfully present for less than five years do not qualify for full Medicaid coverage. However, they may qualify for private coverage subsidized by the government.
• Immigrants who have been lawfully present for five years or longer and some other noncitizens who meet specific noncitizen requirements qualify for the same programs that U.S. citizens can get.

Do You Have a Disability That Meets Social Security’s Standards?

To qualify for SSI-related Medicaid, you must have a disability that meets Social Security’s definition of disability. For adults, Social Security says you have a disability if:

• You have a physical or mental impairment or combination of impairments
• Your impairments limit your ability to work, preventing you from earning Substantial Gainful Activity ($1,550 per month or $2,590 per month if you’re blind), and
• Your condition has lasted or is expected to last for at least 12 months.

If you currently get disability benefits, like Social Security Disability Insurance (SSDI), you already meet Social Security’s disability standards. If not, Michigan's Disability Determination Service (DDS) checks to see if your disability qualifies for Medicaid.

Note: Learn about Social Security’s definition of disability for children under 18 in DB101’s Benefits for Young People article.

If you already have a disability determination from Social Security or think that your disability meets Social Security’s standards, SSI-related Medicaid might cover you.

Do You Have Very Low Resources?

Resources are money and property you own. For SSI-related Medicaid, you and your family must have very low resources:

• If you are single, the most you can have is $2,000 in resources.
• For couples, the limit is $3,000.

Some resources don’t count towards SSI-related Medicaid’s resource limit, like the home you live in, one car, and any money you have in an ABLE account.

If your family’s resources are below the limit, SSI-related Medicaid might cover you.

Do You Have Very Low Income?

To qualify for SSI-related Medicaid, you must have countable income that is $1,255 per month or less ($1,704 or less for couples).

For SSI-related Medicaid eligibility, not all of your income is counted. The way your income is counted for SSI-related Medicaid is very similar to SSI’s countable income calculation:

• Most of your unearned income is counted.
  • Important: SSI and Food Assistance Program benefits are not counted for SSI-related Medicaid eligibility.
• Less than half of your earned income is counted.

This means that if you have a disability determination, you might be able to get a job and make $1,900 per month or more without losing your SSI-related Medicaid, because more than half of your earned income wouldn’t be counted.

If you live alone, try this tool to see if your countable income is below SSI-related Medicaid’s income limit. If you live with others, some of their income may be counted and you should talk to your local county human services agency about whether you qualify for Medicaid coverage.

Your Countable Income:

Your Monthly Earned Income	$
Your Monthly Unearned Income (not including SSI)	$
Your Monthly Impairment Related Work Expenses (IRWEs)	$
	$1,255
	$20
	$65
	$943
Your Monthly Countable Income
Your Annual Countable Income
	$15,060
Federal Poverty Guideline
Your Countable Income as a Percent of FPG

Add to favorites

Add to favoritesAdd to favoritesOne of my favorites

If your income is low enough and you meet all other requirements, you should sign up for Medicaid.

More Ways to Qualify for Medicaid if You Have a Disability

There are other ways to qualify for Medicaid if you have a disability. You might qualify for income-based Medicaid if:

• Your disability does not meet Social Security’s definition of disability. SSI-related Medicaid is only for people who have disabilities meeting this standard.
• You have more resources than are allowed by SSI-related Medicaid.
• You make enough money that you would have to pay a monthly premium for Freedom to Work.

You might qualify for SSI-related Medicaid instead of income-based Medicaid if:

• You make more money at work than income-based Medicaid allows. In that case, you could apply for Freedom to Work.
• You also get Medicare. Income-based Medicaid doesn’t cover people getting Medicare, but SSI-related Medicaid does. It may even help pay your monthly Medicare premiums.
• You are 65 years old or older.

Learn more about income-based Medicaid and Freedom to Work.

How to Sign Up

You can apply for Medicaid:

• Online using MIBridges or HealthCare.gov, or
• By using form DCH-1426 and giving it to your county human services agency.

Note: With MIBridges, you can apply for the Food Assistance Program (formerly Food Stamps), the Family Independence Program (FIP), and other benefits at the same time as you apply for Medicaid.

For help with your application, visit or call your local county human services agency or call the Medicaid Beneficiary Help Line at 1-800-642-3195 or 1-866-501-5656 (TTY).

Staying on Medicaid

Usually, once approved for Medicaid, you continue to qualify as long as your situation doesn’t change. If your income, immigration status, residency, or household size changes, let your county human services agency know within 10 days of the change. You can do this in person, by phone, or by email. When you report your changes, the county tells you whether you continue to get Medicaid or if you have new health coverage options, like individual coverage with subsidies or Freedom to Work.