Understanding SSDI and Medicaid

SSDI is a federal program that provides monthly cash benefits to individuals who can no longer work due to a qualifying disability and who have earned enough work credits through prior employment.

Medicaid, on the other hand, is a state-run health insurance program that offers free or low-cost medical coverage for people with limited income and resources. In Colorado, it’s administered by the Colorado Department of Health Care Policy and Financing (HCPF) and is often referred to as Health First Colorado.

Can You Receive SSDI and Medicaid Together in Colorado?

Yes, it’s possible to receive both SSDI and Medicaid in Colorado, but eligibility depends on your income, assets, and timing.

Typically:

• People who qualify for SSI (Supplemental Security Income) automatically qualify for Medicaid.
• SSDI recipients usually become eligible for Medicare after a 24-month waiting period.

However, many SSDI recipients in Colorado can still qualify for Medicaid coverage during that waiting period or in addition to Medicare, depending on their income level.

When SSDI Recipients Qualify for Medicaid in Colorado

You may be eligible for Health First Colorado (Medicaid) if your total income and resources fall below certain state limits. Even while receiving SSDI payments, if your income remains low enough, Colorado can approve you for Medicaid.

In addition, some individuals can qualify through Medicaid Buy-In for Working Adults with Disabilities (WAwD) — a special program that allows you to work and keep your Medicaid benefits by paying a small monthly premium.

Colorado also provides Medicaid while working (Section 1619(b)) coverage for people who have returned to work but still meet disability criteria.

Medicaid and Medicare Overlap

After receiving SSDI for 24 months, you’ll automatically become eligible for Medicare. However, that doesn’t mean you’ll lose Medicaid. Many Coloradans have both Medicare and Medicaid, known as “dual eligibility.”

When you’re dual eligible:

• Medicare serves as your primary insurance.
• Medicaid covers additional expenses like deductibles, copayments, and prescription costs.

This combination ensures you receive comprehensive health coverage without heavy out-of-pocket costs.

How to Apply for Medicaid While on SSDI

You can apply for Health First Colorado (Medicaid) in one of the following ways:

1. Online: Visit colorado.gov/PEAK to complete your application.
2. By Phone: Call the Colorado Medicaid Customer Contact Center at 1-800-221-3943.
3. In Person: Apply through your local county human services office.

Be prepared to provide your Social Security award letter, income documentation, and proof of residency when applying.