Navigating Medicaid and Medicare Coverage While Transitioning to SSDI

As you transition from SSI to SSDI survivor’s benefits, understanding the complexities of health insurance coverage is crucial. Our blog aims to provide guidance on specific topics related to ACA insurance, including the unique challenges you’re facing.

Overcoming Medicaid Conflict for SSDI Survivors with Inherited Assets

When inheriting money while transitioning to SSDI, you may encounter a conflict with Medicaid eligibility due to asset limits. Here’s what you need to know:

– Ohio Medicaid has asset limits for Aged, Blind, and Disabled (ABD) Medicaid.
– Regular Medicaid in Ohio does not have an asset limit, so you may still qualify based on income alone.

If your income qualifies you for regular Medicaid, you can apply and decline ABD Medicaid due to the asset limit. The Marketplace won’t automatically enroll you in Medicaid if you’re eligible but not enrolled.

Purchasing an ACA Plan Instead of Medicaid

– If you don’t qualify for Medicaid or prefer not to enroll, you can purchase an ACA plan on the Marketplace.
– Even if you’re eligible for Medicaid, you can still buy an ACA plan, but you won’t qualify for subsidies.

To purchase an ACA plan without Medicaid interference:

– Emphasize your income as higher than the Medicaid eligibility threshold on the Marketplace application.
– Provide documentation to the Marketplace showing that you’ve declined ABD Medicaid because of the asset limit.

Medicare Eligibility for SSDI Survivors and Asset Limits

– SSDI recipients are eligible for Medicare after a 24-month waiting period from the date of disability.
– Medicare does not have an asset limit for eligibility.
– However, Medicare Part B has a monthly premium, which may be waived if you meet income and asset requirements.


Navigating health insurance transitions requires careful consideration. If you’re facing a conflict between Medicaid and Medicare eligibility, seek professional guidance from an elder law or Medicaid planning attorney. They can help you understand your options and make informed decisions that protect your financial and health interests.

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