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Medicaid and Medicare

Medicaid is a health care program for people with low incomes and limited resources. In most states, children who get SSI payments qualify for Medicaid. In many states, Medicaid comes automatically with SSI eligibility. In other states, you must sign up for it. And some children can get Medicaid coverage even if they do not qualify for SSI. Check with your local Social Security office, your state Medicaid agency, or your state or county social services office for more information.


Medicare is a federal health insurance program for people age 65 or older and for people who have been getting Social Security disability benefits for at least two years.
There are two exceptions to this rule. Your child can get Medicare if he or she:

  • Has a chronic renal disease and needs a kidney transplant or maintenance dialysis; or
  • Has Lou Gehrig’s disease (amyotrophic lateral sclerosis).

State Children's Health Insurance Program


The State Children's Health Insurance Program enables states to provide health insurance to children from working families with incomes too high to qualify for Medicaid, but too low to afford private health insurance. The program provides coverage for prescription drugs, vision, hearing and mental health services and is available in all 50 states and the District of Columbia. Your state Medicaid agency can provide more information about this program.

Other health care services


When your child gets SSI, we will refer you to places where you can get health care services for your child. These services are under the Children with Special Health Care Needs provision of the Social Security Act. These programs are usually managed by state health agencies.

States call these services by many different names, including Children’s Special Health Services, Children’s Medical Services and Handicapped Children’s Program. Most Children with Special Health Care Needs programs help provide services through clinics, private offices, hospital-based outpatient and inpatient treatment centers, or community agencies.


Even if your child does not get SSI, one of these programs may be able to help you. Local health departments, social service offices, or hospitals should be able to help you contact your local Children with Special Health Care Needs program.

 
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