Is SSI-Related Medicaid Right for You?

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

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

You might qualify for SSI-related Medicaid even if you don't get SSI benefits

Like Supplemental Security Income (SSI), SSI-related Medicaid is for people with disabilities who have low income and low resources. However, some rules are different. For example, SSI-related Medicaid has a higher income limit.

The bottom line: If you get SSI payments, you automatically get Medicaid coverage. If you don't get SSI payments, you still might qualify for SSI-related Medicaid.

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, if their income is at or below 400% of the Federal Poverty Guidelines (FPG), they can get 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 ($1,220 per month or $2,040 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 $1,041 per month or less ($1,409 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:

This means that if you have a disability determination, you might be able to get a job and make $1,600 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:

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

SSI, Medicaid, and DAC

If you used to get Supplemental Security Income (SSI), but your SSI benefits stopped because you started getting Disabled Adult Child (DAC) benefits, you can keep getting SSI-related Medicaid coverage through a special rule documented in the state's Bridges Eligibility Manual. If you are in this situation and you lose your Medicaid coverage, there may have been a mistake and you should talk to a Benefits Planner.

If your income or resources are too high

If you work, look into Medicaid's Freedom to Work program. Freedom to Work has higher income and resource limits than SSI-related Medicaid, though you may have to pay a monthly premium. Learn more about Freedom to Work.

Another option is Medicaid with a spend-down (deductible). With a spend-down, you have to pay the first part of your medical costs each month, before Medicaid starts paying for your health care expenses (similar to having a monthly deductible). The amount you have to pay depends on how much income you have. Talk to your county human services agency about this option.

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:

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.