What counts as extra benefits on Social Security Disability

Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) come with more than a monthly check. Depending on which program you receive and your situation, you may be may have access to to Medicare or Medicaid, help paying for work-related costs, and payments to family members on your record. Some of these are automatic; others require you to report your circumstances or ask for them.

The term "extra benefits" is informal — Social Security calls these add-ons by different names depending on the program and the benefit type. What matters is knowing which ones exist, who gets them, and how to make sure you receive them if you are may have access to.

Key Takeaways

  • SSDI recipients get Medicare automatically after 24 months on the program, regardless of age; SSI recipients must meet income and resource limits to receive Medicaid.
  • Family members — spouses, children, and ex-spouses — may receive payments based on your SSDI record even if they do not have disabilities themselves.
  • Work incentives like the Student Earned Income Exclusion and Plan to Achieve Self-Support (PASS) let you earn money without losing benefits, but you must report your work to Social Security.
  • You can receive a one-time payment to cover work-related expenses like assistive technology, transportation, or training costs through certain programs.
  • Medicaid work incentives in some states let you keep Medicaid even after your earnings rise above the SSI payment level.

Healthcare coverage: Medicare for SSDI, Medicaid for SSI

If you receive SSDI, you become covered by Medicare Part A (hospital insurance) and Part B (medical insurance) automatically after you have been on SSDI for 24 consecutive months. You do not need to do anything — Social Security enrolls you. This happens regardless of your age. Your Medicare coverage begins on the first day of the 25th month of your SSDI entitlement.

If you receive SSI, you are usually covered by Medicaid automatically in most states. Medicaid covers doctor visits, hospital stays, prescriptions, and other medical services. A few states have different rules: some require you to meet additional income or resource tests, and a small number do not automatically enroll SSI recipients. Contact your state Medicaid office or your local Social Security office to confirm your coverage status.

If you are on SSDI and also receive SSI (called "concurrent" benefits), you get both Medicare and Medicaid. This is rare but possible if your SSDI payment is very low.

Family payments on your SSDI record

When you are approved for SSDI, certain family members can receive payments based on your work record. These are called auxiliary benefits. The family member does not need to have a disability themselves. Social Security pays them a percentage of your benefit amount, up to a family maximum.

Family members who may receive payments include your spouse (at any age if caring for your child under 16, or at age 62 or older), your ex-spouse (if married at least 10 years and age 62 or older), and your unmarried children under age 19 (or up to age 19 if in high school full-time). Disabled adult children can receive payments at any age if the disability began before age 22.

You do not apply for family members — they must contact Social Security themselves or you can report them during your application. Social Security will contact them to gather information. The total amount paid to your entire family cannot exceed 150 to 180 percent of your benefit amount, depending on your situation.

Work incentives that protect your benefits while you earn

Social Security offers several programs designed to let you work and earn money without losing your disability benefits immediately. These are called work incentives, and they work differently depending on which program you are on.

For SSDI recipients: The Student Earned Income Exclusion lets full-time students under age 22 exclude up to $8,550 per month in earnings (2024 amount; this changes yearly) when Social Security calculates whether you are working at a substantial level. The Trial Work Period lets you work for nine months in a rolling 60-month window without any reduction to your benefit, regardless of how much you earn. After the trial work period ends, you enter the Extended Period of may be able to access, which lasts 36 months. During this time, you can work and earn above the substantial gainful activity level, and your benefits stop only in months you earn over the monthly threshold (currently $1,550 for non-blind individuals in 2024). If your earnings drop back below the threshold, your benefits restart without a new application.

For SSI recipients: The Plan to Achieve Self-Support (PASS) lets you set aside income and resources for a specific work goal — like paying for training, transportation, or tools — without those amounts counting against your SSI payment. You must have a written plan approved by Social Security. The Impairment-Related Work Expenses (IRWE) deduction lets you subtract costs directly related to your disability — such as attendant care, medical devices, or transportation to work — from your earnings before Social Security counts your income. The Student Earned Income Exclusion works the same way for SSI as for SSDI.

All work incentives require you to report your work to Social Security. Failing to report can result in overpayments you must repay.

One-time payments for work-related costs

Some states and local programs offer one-time grants or reimbursements to help cover immediate work-related expenses. These are separate from Social Security itself but are often coordinated with your SSDI or SSI case.

Common expenses covered include assistive technology (hearing aids, mobility devices, software), work clothing or safety equipment, transportation to training or a new job, and licensing or certification exam fees. The amount and availability vary by state and by program. Your local vocational rehabilitation agency or your Social Security work incentives planning and assistance (WIPA) project can tell you what is available in your area. You can find your local WIPA project at vcu-ntdc.org/wipa.

Medicaid work incentives in some states

Many states have created Medicaid work incentives that let SSI recipients keep Medicaid coverage even after their earnings rise above the SSI payment level. These programs go by different names in different states — some call them "Medicaid continuation" or "Medicaid buy-in" programs.

How they work varies. In some states, you can earn above the SSI limit and keep Medicaid by paying a small premium or cost-sharing amount. In others, Medicaid continues for a set period after your SSI stops. A few states let you keep Medicaid indefinitely as long as you meet certain work requirements.

Not all states have these programs, and the rules differ significantly. Ask your state Medicaid office or your local Social Security office whether your state offers a Medicaid work incentive program and whether you meet the requirements.

Ticket to Work and other employment support programs

The Ticket to Work program is a voluntary program that lets SSDI and SSI recipients work with an approved employment provider — called an employment network — to find and keep a job. While you are using your ticket, Social Security does not count your work toward the trial work period or substantial gainful activity rules. This gives you a longer window to test your ability to work without losing benefits.

You do not have to use Ticket to Work. If you choose to, you assign your ticket to an employment network of your choice. The employment network is paid by Social Security only if you reach certain work milestones, so there is no cost to you. If your work does not go as planned, you can return your ticket and your benefits continue.

Separate from Ticket to Work, you can also work with a vocational rehabilitation agency (funded by your state) to receive training, job coaching, and placement services at no cost. These services are designed to help you return to work.

Frequently Asked Questions

Do I have to pay for Medicare if I receive SSDI?

You pay a monthly premium for Medicare Part B (medical insurance), which is usually deducted from your SSDI check. Part A (hospital insurance) is free. If your SSDI payment is very low, you may may have access to for help paying the Part B premium through your state Medicaid program.

Can my adult child receive benefits on my SSDI record if they became disabled after age 22?

No. Disabled adult children can only receive family payments if their disability began before they turned 22. If the disability started after age 22, they do not may have access to for family benefits on your record, though they may be able to receive SSI or SSDI on their own work record if they have worked.

What happens to my benefits if I work and earn too much?

If you are on SSDI and working, your benefits continue during the trial work period and extended period of may be able to access. After that period ends, your benefits stop in any month you earn above the substantial gainful activity level. If your earnings drop below the threshold later, your benefits restart. If you are on SSI, your payment reduces by $1 for every $2 you earn above the monthly exclusion amount (currently $65 per month).

How do I report my work to Social Security?

Contact your local Social Security office or call 1-800-772-1213 to report your work. You can also report online through your my Social Security account. Report as soon as you start working or when your earnings change. Reporting protects you from overpayments and ensures your benefits are calculated correctly.

Can I receive both SSDI family payments and SSI at the same time?

Yes, if you are a family member receiving auxiliary benefits on someone else's SSDI record and your own SSI payment is higher, Social Security pays you the difference. This is called "deemed" income, and it reduces your SSI payment but does not disqualify you.