If you are disabled (or over 64 years of age), of low income, and never paid into the Social Security system, you would still qualify for benefits. What I have hated over the years is when couples get on up in age and need medical care more, often the spousal income will prevent the severely debilitated person from getting Medicaid. I have seen people that have been married for 50 years get a divorce due to this hardship. Medicaid has been better as far as costs go. (I dunno now).