How to Get Disability Benefits if You Don't Have Health Insurance

If you are applying for Social Security disability benefits, medical evidence is a crucial part of your application. This “evidence” consists of records and treatment notes from your doctors — anything that can help show an official diagnosis, prove your limitations, and demonstrate the severity of your condition. And the best way to get this evidence is by regularly seeing doctors for medical care.

Technically, you’re free to apply for disability even if you don’t have health insurance. However, if you aren’t receiving regular medical treatment, it will be much more challenging to show the Social Security Administration (SSA) why you need benefits.

Take a look at what you need to know about how to get disability without insurance.

Do I need health insurance coverage to qualify for disability?

Technically, disability applicants are not required to have health insurance coverage. Your health insurance status does not determine your eligibility for SSDI or SSI.

However, if you’re applying for disability benefits, it’s crucial to have medical evidence that proves your disability. So, it is important to be receiving some kind of medical treatment. And, of course, getting comprehensive medical care is easier and much more affordable if you have health insurance.

Can I apply for disability without a doctor?

Yes, you can apply for disability benefits even if you don’t have a doctor you regularly see. But it’s going to be much more challenging to prove your disabling condition to the SSA. They’ll consider past medical records, but what’s most helpful is up-to-date records — doctor’s notes, treatment logs, and any test results from the past three months.

We recommend regularly seeing both a primary care provider (PCP) and at least one specialist who treats your specific condition. It’s difficult to navigate your way around how to get disability without a doctor.

What is a consultative exam?

If you don’t have enough medical evidence on your disability application, the SSA will likely ask you to do a consultative examination (CE). For this exam, they’ll send you to a disability examiner doctor for a brief appointment to help determine whether you meet the SSA’s definition of disability. 

Consultative exams can be helpful. But in most cases, this exam won’t be enough to get Social Security disability insurance. Consultative exams tend to be quick and surface-level. What you really need for your disability claim are thorough, detailed notes from a personal doctor whom you regularly see. 

Where to get medical help without insurance

If you cannot work because of a medical condition, affording health insurance premiums or paying for treatment out-of-pocket can be difficult or impossible. However, building up your medical history is crucial to secure disability benefits. 

Consider the following organizations for medical treatment if you’re uninsured:

• Health Resources and Services Administration (HRSA) Health Centers: These centers receive federal funds and offer primary and preventive care no matter what you can pay. 

• Medicaid: Medicaid details vary by state, but the program includes coverage for inpatient and outpatient hospital services, doctor appointments, and laboratory and X-ray services.

• National Association of Free and Charitable Clinics (NAFCC): These nonprofit clinics provide medical, dental, pharmaceutical, vision, and behavioral health services.

• National Association of Community Health Centers (NACHC): These community health centers service all patients regardless of ability to pay. 

• Substance Abuse and Mental Health Services Administration (SAMHSA): SAMHSA has a database to helps people find affordable access to mental healthcare or addiction treatment. 

You can also speak with a social worker or the financial assistance department at a local hospital to get more ideas about where to access low-cost medical treatment and care. Some urgent care centers might offer reduced costs and affordable care for people without insurance. 

In some cases, you might be able to low-cost specialist treatment at an academic medical center. To get benefits, however, working with the same doctor long-term will be most beneficial to build your disability case. 

Find more ideas in our guide that shares housing, healthcare, and legal resources for people with disabilities. 

How a disability lawyer can help

A helpful tip for how to get disability without insurance is to work with a lawyer. An experienced Social Security disability lawyer will be able to help you build a timeline of your medical conditions, symptoms, and treatment history to include with your disability application. They can also recommend what medical evidence would be most helpful for your condition and the best way to obtain it. Here at Atticus, we offer free legal advice for people seeking disability. We can also introduce you to a disability lawyer if you’d like. Take our two-minute disability quiz to give us more information about your condition, and give us a call to get started.

Related resources:

Medical Source Statements (MSS): What They Are and When You Need One

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How to Obtain Your Medical Records for Social Security Benefits

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