We often hear the question, “Does Social Security disability count as income for Medicaid?” If you depend on these services, it is essential to understand how your benefits will impact your ability to maintain sufficient support, no matter your disability status.
When you get Social Security Disability Insurance (SSDI), it may impact your eligibility for Medicaid, which provides healthcare for low-income individuals. If you need to know how SSDI affects Medicaid, we can help.
While SSDI is considered income when determining Medicaid eligibility, the full picture is more complex, and several factors come into play.
How SSDI Impacts Medicaid Eligibility
Medicaid eligibility is generally based on your income level. Each state sets its income thresholds, often tied to the federal poverty level (FPL). In 2024, the Federal Poverty Level (FPL) income limits are as follows:
- $15,060 annually for a single person
- $20,440 annually for a couple
- $25,820 annually for a family of three
For Medicaid eligibility, the income limits may differ. For non-elderly adults, the income limit is generally set at 133% of the FPL, translating to approximately:
- $20,120 annually for a single individual
- $27,691 annually for a couple
If your monthly SSDI payments exceed the Medicaid income limits for Florida, you may no longer qualify for Medicaid, especially during the waiting period before you are eligible for Medicare. This leaves many SSDI recipients in a difficult position, as they may lose Medicaid benefits before gaining Medicare coverage.
Social Security Disability and Medicaid
The answer to the question, “Does Social Security disability count as income for Medicaid?” is critical. Yes, SSDI is counted as income. Medicaid uses “modified adjusted gross income” (MAGI) to assess eligibility, and SSDI falls into that category. Even though SSDI benefits are not always taxable, they still count as income for Medicaid purposes.
However, certain types of income are not included when calculating Medicaid eligibility, including:
- SSI (Supplemental Security Income)
- Workers’ compensation benefits
- Veterans’ disability benefits
- Child support payments
In many states, including Florida, SSDI recipients with a monthly income above $1,670 (or $2,265 for couples) may be disqualified from Medicaid due to these limits.
Medicaid Expansion and the Affordable Care Act (ACA)
The Affordable Care Act (ACA) widened Medicaid eligibility in many states. For residents in the 40 states that adopted this expansion, the increased limit allows more SSDI recipients to qualify for Medicaid during the Medicare waiting period.
Unfortunately, ten states—including Florida—did not expand their Medicaid programs, meaning SSDI recipients in these states may face more stringent income restrictions.
Next Steps: Navigating SSDI and Medicaid Eligibility
Determining how Social Security disability and Medicaid work together can be challenging, especially given the variability in state programs. Since your SSDI benefits will count as income for Medicaid, it is crucial to understand Florida’s rules and any available programs that might allow you to maintain Medicaid coverage.
If you have been denied Medicaid due to income, you also have the right to appeal. Contact Florida’s Medicaid agency for more information, and consider seeking legal advice if needed to explore your options.
Whether you are appealing a denial or seeking guidance on state-specific eligibility criteria, there are ways to secure the healthcare coverage you need during the waiting period for Medicare.
We Are Here to Help
When asking, “Does Social Security disability count as income for Medicaid?” turn to the experienced team at Culbertson, Jacobs & LaBoda. We understand the complexities associated with Social Security disability and Medicaid. Our team aims to help you understand your options and protect your access to medical coverage. We can also help you understand the latest Cost of Living Adjustment, and how it affects your benefits.
Contact us today to learn how we can assist you in navigating the complexities of Social Security Disability claims, including appealing denied claims and exploring options to secure the benefits you need for ongoing financial and medical support.