Can I receive disability for my mental health condition? I need help understanding/applying for SSI/SSDI/Medicaid/Medicare.

Getting insurance or understanding your current insurance plan can be complicated.  NAMI’s Understanding Health Insurance section explains the basics and can help you to begin navigating the system successfully.  You may also wish to consult the Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI) page of NAMI’s website that provides an overview of each type of assistance and thresholds for qualification.  Additionally, information on both forms of disability can be found on the website of the Social Security Administration at Supplemental Security Income (SSI) Benefits and Disability Benefits (SSDI).

Unless you and your family are able to pay out-of-pocket for private, long-term care, you may want to explore whether or not your loved one qualifies for disability benefits that will provide a guaranteed income and access to Medicare and/or Medicaid.  For many county services, being qualified by the Social Security Administration for disability income and receiving Medicaid and/or Medicare is a primary consideration when applying for service.  In many cases, if a person is receiving disability income, their housing and services are covered monthly by no more than a payment of one-third of their monthly disability income.

Navigating the Social Security Disability Income (SSDI) application process can be challenging. We would suggest consulting the following resources:

  • The Social Security Administration is the agency that administers and manages the Social Security Income (SSI) application process. Three options for applying for benefits:
  • National Disability Rights Network (NDRN)/State Protection and Advocacy partners with the Social Security Administration to investigate claims from disabled individuals who receive disability income when they believe a “Representative Payee’ is mismanaging their money.  State agencies will investigate complaints.
  • Representative Payee Review Program, (800) 772-1213, is for individuals currently receiving SSI/SSDI. In some cases the Social Security Administration has carefully selected a person, or an organization to help by serving as a "Representative Payee".  The Social Security Administration has partnered with the National Disability Rights Network and Protection and Advocacy (P&A) organizations to conduct reviews on Representative Payee performance and provide Representative Payees support to better understand their role and responsibilities.  The SSA website offers a comprehensive FAQ section.  If someone believes their rights are being violated by their representative payee should contact their State’s National Disability Rights Protection & Advocacy organization.
  • National Organization of Social Security Claimants’ Representatives (NOSSCR), (800) 431-2804, provides referrals for paid representation of persons seeking SSI.
  • National Association of Disability Representatives (NADR), (800) 747-6131, provides referrals for paid lawyers/non-lawyers representatives to assist in accessing SSI/SSDI.
  • Allsup, (800) 279-4357, is an organization specializing in disability services and offer expert representation in helping individuals navigate the process of applying for and appealing SSDI decisions. Fee may apply upon winning case.

Finally, if you have questions or concerns about Medicaid and Medicare eligibility or benefits, contact the Centers for Medicaid and Medicare Services (CMS) or call (800) 633-4227.  Many people have also secured Medicare and Social Security assistance through the Medicare Rights Center, which provides their MRC Consumer Hotline at (800) 333-4114.

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Call: 800-950-NAMI (6264) 

Text: 62640 

Webchat: www.nami.org/help  

Email: helpline@nami.org

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