Jane Dotson
If you are on SSDI in Illinois and want to get state medical insurance, there are a few options to consider. Firstly, Illinois does not have a state disability program, but residents can apply for disability plans through the federal government or private insurance companies. The federal government offers Social Security Disability Insurance (SSDI) to those who have worked previously but now have a medical condition that impedes their ability to work. Alternatively, Supplemental Security Income (SSI) is available for those with limited income and assets. After receiving SSDI benefits for two years, individuals automatically qualify for Medicare health coverage. However, if you are seeking additional coverage, you can apply directly to your state Medicaid agency to determine eligibility.
| Characteristics | Values |
|---|---|
| State | Illinois |
| State disability program | No |
| Federal disability program | Social Security Disability Insurance (SSDI) |
| Private disability program | Yes |
| SSDI eligibility | Must have worked long enough, paid Social Security taxes, and have a disability that meets Social Security's standards |
| SSDI payment | Maximum of $3,822 in 2024; average of $1,372.64 |
| Medicare eligibility | Automatic after receiving SSDI benefits for two years |
| Medicaid eligibility | Apply directly to the state Medicaid agency |
| Private health plan eligibility | Available through the Marketplace while waiting for Medicare coverage to start |
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SSDI and Medicare
If you receive Social Security Disability Insurance (SSDI), you may already have Medicare or will be in a 24-month waiting period before it starts. You have health coverage options in either case. If you are turned down for Medicaid, you may be able to enrol in a private health plan through the Marketplace while waiting for your Medicare coverage to begin. You may qualify for lower costs on Marketplace coverage based on your income and household size. When asked about your income on your Marketplace application, be sure to include your SSDI income.
Medicare is divided into two parts: Part A (Hospital Insurance) and Part B (Medical Insurance). If you are receiving Social Security disability benefits, you will automatically receive Medicare after receiving disability benefits for 24 months. If you have ALS, you will automatically receive Medicare as soon as you start receiving disability benefits.
If you have Medicare Part A but did not take Part B coverage when it was first offered, you can sign up for it during a general enrollment period (January 1st through March 31st of each year) or a special enrollment period. The special enrollment period is available if you have been covered under a group health plan based on your own or a family member's current employment status since the month you were first eligible for Part B. You can sign up for Part B during any month you are covered under the group health plan based on current employment status, or during the 8-month period that begins the first full month after the employment or the group health plan coverage ends, whichever comes first.
If you return to work and engage in substantial gainful activity, you may receive at least 93 months of hospital and medical insurance after the trial work period as long as you still have a disabling impairment. This provision allows health insurance to continue when a beneficiary goes to work. After premium-free Medicare coverage ends due to work, beneficiaries can purchase Medicare hospital and medical insurance if they continue to have a disability at the end of the 93-month period.
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Medicaid eligibility
To be eligible for Medicaid in Illinois, you must be a US citizen or fall within a qualified category of non-citizen, such as a refugee or a legal permanent resident. Immigrants admitted to the US after August 21, 1996, are ineligible for the first five years after entry.
Medicaid is available for low-income people and families, with varying income and asset rules for different groups. For example, adults with income up to 138% of the federal poverty level are eligible, while children in households with income up to 318% of the federal poverty level are covered. Women who have recently given birth with incomes up to 213% of the federal poverty level are eligible for up to 12 months after giving birth. Young adults under 26 who were formerly in foster care are also covered.
Additionally, adults who are disabled, blind, or aged 65 and older have different income limit rules. For instance, a single Nursing Home Medicaid applicant in 2025 must meet the following criteria:
- Income under $1,304.17 per month
- Assets under $17,500
- Require a nursing home level of care
It's important to note that not meeting all the criteria does not necessarily mean one is ineligible or cannot become eligible. There are also different eligibility requirements for each state, and certain life events may qualify you for a Special Enrollment Period.
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Applying for SSDI
To apply for SSDI, or Social Security Disability Insurance, you must be unable to work due to a medical condition that is expected to last at least 12 months or result in death. You must also not have been denied disability benefits in the last 60 days. The application process can be started online, and you will need to provide detailed information about your medical conditions, as well as your work history.
To apply for SSDI online, you will need to create an account on the Social Security Administration website. Once you have logged in, you can start the application process by completing the Adult Disability Checklist, which will help you gather the necessary information. This includes personal information such as your name, Social Security number, and date of birth, as well as detailed information about your medical conditions, treatments, and work history.
You will also need to provide information about your work history, including the names, addresses, and phone numbers of all employers you have worked for in the last five years, as well as the dates of employment. If you have received any workers' compensation or similar benefits, you will need to provide proof of these benefits, such as award letters or pay stubs.
In addition to the online application, you may also need to submit medical records and other documentation to support your claim. This can include W-2 forms, tax returns, and medical documents. If you are providing birth records or documents from the Department of Homeland Security, you must bring them to a Social Security office, rather than mailing them, as these documents can be difficult and expensive to replace if lost.
Once your application is complete, you can submit it online or by mail. If you have all the necessary information and documentation, your application will be processed, and you will be notified of the decision. If your application is approved, you will begin receiving monthly SSDI payments, and you may also be eligible for Medicare.
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SSDI and work
If you are on SSDI, or Social Security Disability Insurance, it means that you have been deemed unable to work in any "substantial gainful activity" by the Social Security Administration (SSA). This typically means any work where you would make $1,130 per month or more. However, the SSA allows a Trial Work Period (TWP) during which you can earn any amount without affecting your benefits. After this period, if your earnings are consistently above the SGA limit, your benefits might be reconsidered. The TWP allows SSDI beneficiaries to test their ability to work for up to nine months without losing their benefits.
The amount of money you earn while working will reduce the amount of benefit you collect. The first $85 you earn in a month from working will not be counted. Anything above that baseline will be subtracted, fifty cents for every dollar, from your benefit collected. For example, $1,130 (the maximum amount you can earn and collect benefits) minus $85 (the baseline earned income not counted) equals $1,045.
In the five years following your TWP, you are automatically qualified for the program if you stop working, meaning you can collect benefits without reapplying. At any time in the three years after the end of your TWP where you earn less than your established SSDI benefit, you can apply to collect the SSDI benefit to compensate for this shortfall.
If you are on SSDI in Illinois, you may be eligible for a medical card from the Illinois Department of Human Services (IDHS). To be eligible, you must be a resident of Illinois, a citizen of the US or an immigrant legally admitted for permanent residence, and be aged 16 or over and under 65. You must also meet the Social Security Administration's definition of disability, which can be proven by receiving SSDI benefits.
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SSDI and SSI
If you are on SSDI in Illinois, you may be eligible for state medical insurance through the state's Medical Assistance Programs. To be eligible for a non-spenddown medical card, you must be a resident of Illinois, a US citizen or eligible non-citizen, aged 16 or over and under 65, and meet the Social Security Administration's definition of having a disability. You can prove your disability through receipt of SSDI or SSI benefits or a determination by the state's Client Assessment Unit. If eligible, you can apply for the medical card at a local DHS office and receive it without paying monthly premiums.
Now, SSDI, or Social Security Disability Insurance, provides monthly payments to people with disabilities that limit or stop their ability to work. It is tied to your work history, and the payment amount is based on your work history before your disability. Your spouse, former spouse, and children may also be eligible for benefits when you start receiving SSDI.
SSI, or Supplemental Security Income, is for individuals with little to no income who are either 65 or older or have a disability. It does not require a work history and provides money to cover basics like food, clothing, and housing. Depending on eligibility, you may be able to collect both SSDI and SSI benefits simultaneously, known as "concurrent" benefits.
To apply for SSDI or SSI, you can do so online, by phone, or in person. There is a five-month waiting period for SSDI benefits to start after approval, and you must report changes to your work, income, and personal information. For SSI, you must live in one of the 50 states, the District of Columbia, or the Northern Mariana Islands and be a US citizen or national.
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Frequently asked questions
SSDI stands for Social Security Disability Insurance, a federal program that gives monthly payments to people who have worked, paid Social Security taxes, and now have disabilities that limit their work ability.
To qualify for SSDI, you must have worked long enough to be covered and have a disability that meets the Social Security Administration's standards. The disability must be proven to make it impossible for you to work, and it must be expected to last at least another year or for the rest of your life.
The average SSDI payment in Illinois is $1,372.64, though the maximum possible payment in 2024 is $3,822. The amount you receive is determined by your personal income and work history.
After receiving SSDI benefits for two years, you automatically get Medicare health coverage. If you are within the 24-month waiting period, you can apply for Medicaid or a private health plan through the Marketplace.
SSI stands for Supplemental Security Income and gives monthly payments to people with disabilities who have low income and limited assets. Unlike SSDI, you do not need to have worked in the past to get SSI.
