People who refuse to get treatment for their illness will be stripped of their sickness benefit under a new crackdown to be tested in a £25 million government trial.
The same "conditionality" used to force the jobless to seek work for their welfare payments is to be extended to those with health complaints.
A series of pilots for what has been described as "tough love" by Downing Street sources, will be announced before Christmas.
Chancellor George Osborne is seeking ways to slash a further £10 billion from the welfare budget by 2016/17 on top of £18 billion of cuts already announced.
Under the proposals claimants would be expected to attend regular sessions with a health care professional who could require them to attend therapy and other treatments to help them recover.
It is unclear exactly what conditions would be caught but No10 suggested drug and alcohol addicts who failed to attend rehab courses would be among them in the initial trials.
Funding for the pilots has been agreed, they said.
"This is a tough love approach towards our aim of ending the something for nothing culture in benefits.
"It's right that we provide support for people in need, but we should also expect something back in return.
"We are already helping people back into work through unemployment benefit conditionality. Now we are looking at transferring that principle to sickness benefits, so that for those people who are sick but able to take practical steps to improve their health, the benefits system encourages them to get better.".