Applying for SSI? Your application may also be treated as an application for Medicaid. Here’s how to find out if you’re automatically enrolled in the program.
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When you apply for Supplemental Security Income, the federal assistance program that offers monetary funds for low-income and low-resource individuals, your application might also be treated as a Medicaid application. In fact, you may have heard that you’re automatically enrolled for Medicaid when you apply for the SSI, but that’s not necessarily true for everyone.
Not to be confused with Medicare, Medicaid is a joint state and federal program that can help cover medical costs for qualifying individuals. And while you still may be eligible for Medicaid and have applied for SSI, some states require a separate application.
Below, we’ll go over the differences between Medicaid and Medicare, what states require separate applications for Medicaid and dual eligibility for both programs.
For more, don’t miss the Supplemental Security Income payment schedule and how to apply for SSDI.
What is Medicaid?
Medicaid is a joint federal and state program that covers medical costs for some people with limited income and resources. Guidelines have been set by the federal government that all states must abide by for consistency, though each state runs its own individual program and can have different eligibility requirements.
If your income is too high to qualify for Medicaid, your children might still qualify through the Children’s Health Insurance Program (CHIP), which will cover medical and dental care for uninsured children through the age of 19.
What is Medicare?
Medicare is a federal health insurance program for people 65 and older. Some individuals under the age of 65 may qualify for Medicare if they have certain disabilities or conditions like End Stage Renal Disease (ESRD) or Amyotropic Lateral Sclerosis (ALS aka Lou Gehrig’s disease). If you don’t apply for Medicare on time, you may even be penalized for it.
Medicare is broken into multiple “parts” A through D, some of which are optional where others are likely already free for most people if they’ve worked long enough. These parts are essentially insurances for the following:
Part A: Hospital Insurance
Part B: Medical Insurance
Part C: Medicare Advantage Plan
Part D: Drug Coverage
Not all states auto-enroll you in Medicaid
You might have heard that once you apply for Supplemental Security Income, you’ll be automatically enrolled in Medicaid. While that’s true for a majority of the country, it isn’t for all states. And even then, some states have tighter restrictions for who qualifies.
The states are broken into three types:
1634 states: These states automatically notify the state Medicaid office upon designating an individual as eligible for SSI and can automatically enroll you.
SSI criteria states: These states require a separate application for Medicaid but use the same criteria as SSI to determine eligibility.
209b states: These states require a separate application for Medicaid and have at least one criterion that is more restrictive than the typical SSI eligibility criteria. The restrictions can vary from state to state and can relate to income or resource limits.
Here’s a breakdown of what states automatically enroll you in Medicaid, which states require a separate application, and which states both require a separate application and have more restrictive eligibility requirements.
| 1634 States | SSI Criteria States | 209b States |
|---|---|---|
| Alabama, Arizona, Arkansas, California, Colorado, Delaware, District of Columbia, Florida, Georgia, Indiana, Iowa, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Mississippi, Montana, New Jersey, New Mexico, New York, North Carolina, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Vermont, Washington, West Virginia, Wisconsin and Wyoming. | Alaska, Idaho, Kansas, Nebraska, Nevada, Oregon and Utah | Connecticut, Hawaii, Illinois, Minnesota, Missouri, New Hampshire, North Dakota, Ohio, Oklahoma and Virginia. |
Connecticut, New Hampshire and Missouri don’t include nonblind individuals under the age of 18 in their definition of disability, though nonblind children can qualify for Medicaid under the Temporary Assistance for Needy Families (TANF) program.
It’s also important to note that some individuals may still qualify for Medicaid even if they aren’t eligible for SSI, depending on the rules of the state in which the individual resides.
Indiana was previously a 209b state but converted to automatic enrollment in 2014.
You can qualify for both Medicaid and Medicare
Under what’s known as dual eligibility, some individuals may be able to qualify for both Medicaid and Medicare as long as state and federal requirements are met for both. If it wasn’t obvious, being eligible for both programs can provide wider health coverage versus just being enrolled in one.
If you’re enrolled in both programs, Medicare will be your primary provider and Medicaid will pay second. Medicaid can also help cover services and prescriptions that otherwise would not be covered with Medicare alone.
Where can I find more information?
If you still have questions or concerns about eligibility for Medicaid, you can check out the official webpage that will allow you to find more information about your individual states’ eligibility requirements and enrollment information.
For more, be sure to find out the max amount of SSI money you can get for 2025.
Blake has over a decade of experience writing for the web, with a focus on mobile phones, where he covered the smartphone boom of the 2010s and the broader tech scene. When he’s not in front of a keyboard, you’ll most likely find him playing video games, watching horror flicks, or hunting down a good churro.
