How to Pay for Services

Eligibility for most Texas Health and Human Services disability programs are based on a person’s ability to perform activities of daily living, income and resources. Services are paid for most often by a combination of federal and state funds.

The programs that most often pay for services are a combination of Medicaid, Medicare and Social Security.

Social Security Disability Benefits

If you have a disability, you may be eligible for one of the following programs:

  • Social Security Disability Insurance (SSDI) pays benefits to people who can’t work because they have a medical condition that’s expected to last at least one year or result in death. Social Security looks at two things when considering eligibility: A recent work test, based on your age at the time you became disabled; and a duration of work test to show that you worked long enough under Social Security. (Certain blind workers have to meet only the duration of work test.)
  • Supplemental Security Income (SSI) provides cash to people who are older, blind or who have a disability and who have little or no income. Benefits are paid based on financial need. The money is designed to meet basic needs for food, clothing and shelter.

To file a disability claim, visit www.socialsecurity.gov or call 800-772-1213 to make an appointment to file a claim at your local Social Security office or to set up an appointment for someone to take your claim over the phone.

Texas Health and Human Services completes disability determination for SSDI and SSI applicants in Texas. However, the Social Security Administration is responsible for making the final decision as to who is qualified for benefits.

If you have already filed a disability claim with Social Security, you may call 512-437-8000 or 1-800-252-7009 to provide additional information or questions concerning your claim.

Medicaid

Medicaid provides health coverage to eligible people who have disabilities. Each state has its own rules about who’s eligible, and what Medicaid covers. Medicaid not only pays for doctor visits, prescriptions and hospitalization, but it also may pay for medical equipment, assistive devices, personal attendants to help you with everyday tasks, and other services in your home or community. It also can be used to pay for independent living, assisted living or an intermediate care facility.

If you have a disability and work, you may be eligible for a Medicaid Buy-in program that offers low-cost Medicaid health care services — including community-based services and supports – to people with disabilities who work. Some people in the program might have to pay a monthly fee.

Parents who have a child with a disability and who make too much money to get traditional Medicaid may be eligible for the Medicaid Buy-in for Children program to help with medical bills.

Medicare

People who get Social Security disability benefits for two years automatically are enrolled in Medicare hospital and medical insurance. The hospital insurance helps pay for hospital stays and some follow up care. The medical insurance helps pay doctor’s bills, outpatient hospital care and other medical services.