Automatic Medicaid Eligibility for Supplemental Security Income (SSI) Recipients

Recipients of Supplemental Security Income (SSI) are usually eligible for Medicaid, and in many states SSI recipients automatically qualify for Medicaid. This makes it much easier for many seniors to receive Medicaid Long Term Care benefits like nursing home coverage or in-home personal care. This is known as an eligibility pathway to Medicaid, or the SSI pathway to Medicaid benefits.



How SSI and Medicaid are Linked

Supplemental Security Income (SSI) is a cash benefit provided through the federal government’s Social Security Administration to recipients who meet these criteria:

  • SSI recipients are low-income, meaning they earn less than a certain amount every month and have assets whose total value falls under a specified limit.
  • SSI recipients are aged, blind, or disabled.

In this way, SSI is quite similar to Medicaid, which also has income and asset limits. Because the criteria are so close, in fact, seniors who are eligible for SSI are also eligible for one of the three types of Medicaid Long Term Care – Nursing Home Medicaid, Home and Community Based Services (HCBS) Waivers or Aged, Blind and Disabled (ABD) Medicaid. In many states, SSI recipients are automatically accepted into Medicaid, and in some of those states they don’t even need to apply for Medicaid because the application is the same.

There are additional steps to receive nursing home (institutional) Medicaid or HCBS waivers, described below, but the application process should move faster.


Eligibility Requirements for Medicaid and SSI

Supplemental Security Income has the same eligibility requirements for all Americans, whereas Medicaid eligibility rules are different depending on the state in which one resides. Despite the state variances, the criteria for acceptance often overlap.


To be eligible for SSI in 2024, single applicants must have an income of $943/month or less, and married couples must have a combined income of $1,415/month or less.

Medicaid’s income eligibility criteria varies depending on the state where you live and the program you’re applying for Nursing Home Medicaid, Home and Community Based Services (HCBS) Waivers or Aged, Blind and Disabled Medicaid. In many states, the ABD Medicaid income limits are exactly the same as SSI – $943/month for an individual and $1,415/month for a married couple. In other states, the ABD Medicaid income limits are higher.

The 2024 individual income limit for Nursing Home Medicaid and HCBS Waivers in most states is three times the SSI income limit –  $2,829/month –  and the limits for married couples with both spouses applying to either of those two programs is double that amount, or $5,658/month. Those limits are lower in some states, but none are higher than the SSI limits.

So, the SSI income limits are equal to or lower than the Medicaid financial limits for any of the three Medicaid Long Term Care programs, meaning that anyone who is income eligible for SSI in 2024 is also income eligible for Medicaid Long Term Care.


While Medicaid’s income limits are usually higher than the SSI income limits, the asset limits for the two programs are often the same: $2,000 for a single individual and a combined $3,000 for a couple.

Countable assets for eligibility purposes often do not include your primary home, or some other items like your primary vehicle, furniture, appliances and personal items like wedding rings. But most assets are countable, including bank accounts, retirement accounts, stocks, bonds, certificates of deposit, secondary vehicles, vacation homes, cash and anything that can be easily converted into cash. For more on which assets are countable and which are not, click here.

 Toolbox: To find the specific Medicaid eligibility criteria in one’s own state, visit our Medicaid Eligibility Requirements Finder tool. It takes less than 1 minute and no personal information is required. If you want more in depth information, go to our 50-State Guide to see the guidelines in your state.


Medical / Functional Criteria

In addition to the financial requirements, the three types of Medicaid Long Term Care —Nursing Home Medicaid, Home and Community Based Services (HCBS) Waivers and Aged, Blind and Disabled (ABD) Medicaid — and the Supplemental Security Income program also have functional, also called medical or physical, requirements.

Nursing Home Medicaid requires applicants to have a Nursing Facility Level of Care (NFLOC). This means they need the type of 24/7 care and supervision that is normally associated with a nursing home, although how that is measured can vary by state. Most HCBS Waivers programs in most states also require applicants to have a NFLOC, although the medical requirement for some HCBS Waiver programs is slightly less strict. To get basic healthcare coverage through ABD Medicaid there is no medical requirement, but ABD Medicaid applicants/recipients who want long-term care services and supports must show a medical need to be eligible for those long-term care benefits.

There are also some medical or functional requirements for SSI. Recipients must meet one of the following criteria:

  • Be 65 or older
  • Be partially or fully blind
  • Have a medical condition that impairs the ability to work

While someone who receives SSI is automatically financially eligible for ABD Medicaid benefits, the functional criteria element means there will be additional steps in order to qualify for Nursing Home Medicaid or HCBS Waivers. Those steps will usually include an in-person examination coordinated by the applicant’s state Medicaid offices to determine their level of care needs.


In Which States Do SSI Recipients Automatically Qualify for Medicaid?

Does receiving Supplemental Security Income automatically qualify one for Medicaid? Does automatic qualification mean that someone who receives SSI does not need to apply for Medicaid? It depends on the state. In order to receive Medicaid Long Term Care benefits in a nursing home or through a Home and Community Based Services Waiver, one will still need to be evaluated for functional need.

States where SSI recipients automatically qualify for Medicaid and don’t need to fill out a Medicaid application:
Alabama, Arizona, Arkansas, California, Colorado, Delaware, D.C., 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.

In these states, people who are approved for SSI are enrolled in Medicaid by the Social Security Administration. When someone who resides in these states is accepted for SSI benefits, they’ll receive information with their SSI award letter that says they’ve also been enrolled in Medicaid.

To receive Nursing Home Medicaid or HCBS Waivers in these states, the additional step of being evaluated for functional need is necessary. To learn more about applying for Nursing Home Medicaid,  click here. To learn more about applying for HCBS Waivers, click here.

States where SSI recipients qualify but still need to apply for Medicaid:
Alaska, Nebraska, Utah, Idaho, Nevada, Kansas, and Oregon.

In these states, after receiving a notification that SSI has been awarded, you can go through the process of applying for Medicaid knowing you’ll be accepted. Upon acceptance for SSI benefits, the Social Security Administration will provide information on how to apply for Medicaid and the process should move fairly quickly.

If you need to know how to apply for Medicaid, including how to apply for long-term care benefits, you can click here to find the Medicaid office nearest you.

States where SSI does not guarantee Medicaid eligibility:
Connecticut, Hawaii, Illinois, Minnesota, Missouri, New Hampshire, North Dakota, Ohio, Oklahoma, and Virginia.

In these states, income limits might be slightly different. Asset limits and the criteria for disability might also be different from SSI. Often, the Medicaid Long Term Care asset limit in these states is lower than the SSI asset limit. These states are sometimes called 209(b) states.

Residents in these states should apply for Medicaid through the nearest office. Click here for contacts and guidance.