Social Security Disability vs. State Disability

People often confuse the term Social Security Disability Insurance (“SSDI”) with State Disability Insurance (“SDI”), when in reality the programs are quite different. There are 5 states that have state-mandated disability insurance requirements: California, Hawaii, New Jersey, New York, and Rhode Island. The territory of Puerto Rico also has mandatory insurance requirements.

SSDI is administered by the federal government through the Social Security Administration (“SSA”). It provides a cash benefit to disabled workers who have paid into the Federal Insurance Compensation Act. A person’s monthly benefit for 2017 can be as low as a few dollars to as high as $2,687.00 depending on one’s contributions to FICA. If you have minor children, the benefit may be increased. SSDI is not meant to be a full income replacement, however, which often surprises some people.

Recipients of SSDI also qualify for Medicare once they have been entitled to SSDI benefits for 24 months. Recipients can remain on SSDI until SSA has determined that a disability has improved or until the recipient is well enough to return to work. At retirement age, a disabled person can still receive his/her SSDI rate if this rate is higher than his/her retirement rate. However, SSA will start referring to these benefits as retirement benefits regardless of what rate you are being paid at.

State disability programs may vary from state to state. For example, California has its own state-run disability program due to their high cost of living. It is a temporary program and only lasts for a maximum of one year. Benefits cannot be extended past one year even if you remain disabled after those 365 days. The program is administered by the Employment Development Department (“EDD”), a State agency that also administers unemployment. Recipients of SDI do not receive health insurance with this benefit, but recipients may be able to file for Medi-Cal separately if they meet the financial requirements.

You can apply for SSDI and SDI simultaneously, but please note that there can be an offset of these public benefits if you are awarded.

If you or someone you know is unable to work due to a medical condition, please contact us for a free case evaluation!

By: Thomas A. Klint of Premier Disability Services, LLC®

It’s Open Enrollment for Medicare

Each year, you have a chance to make changes to your Medicare Advantage or Medicare prescription drug coverage for the following year. The open enrollment period for Medicare for 2018 coverage began on October 15, 2017 and will continue through December 7, 2017.

During this annual enrollment period you can make changes to various aspects of your coverage.

• You can switch from Original Medicare to Medicare Advantage, or vice versa.
• You can also switch from one Medicare Advantage plan to another, or from one Medicare Part D (prescription drug) plan to another.
• And if you didn’t enroll in a Medicare Part D plan when you were first eligible, you can do so during the general open enrollment, although a late enrollment penalty may apply.

If you want to enroll in a Medicare Advantage plan, you must meet some basic criteria.

• You must be enrolled in Medicare Part A and B.
• You must live in the plan’s service area.
• You cannot have End-Stage Renal Disease (some exceptions apply).

There are specific times when you can sign up for these plans, or make changes to coverage you already have. You don’t need to sign up for Medicare each year. However, each year you’ll have a chance to review your coverage and change plans.

If you didn’t sign up for Medicare A and B when you were first eligible, you have a chance to do so each year from January 1 to March 31, with coverage effective July 1.  You may be subject to a late enrollment penalty however.  For Medicare Part B, the penalty is an additional 10 percent of the premium for each 12-month period that you were eligible but not enrolled.

Read more here: https://www.medicare.gov/sign-up-change-plans/when-can-i-join-a-health-or-drug-plan/when-can-i-join-a-health-or-drug-plan.html

Plan finder: https://www.medicare.gov/find-a-plan/questions/home.aspx

By: Joyce Trudeau of Premier Disability Services, LLC®

Will I Automatically Receive Medicaid When I Receive SSI?

Federal law requires States to provide health insurance to certain groups. Medicaid is a program which provides health insurance to low-income individuals who are 65 or older, are blind, or disabled. However, whether a disabled individual automatically receives Medicaid coverage depends upon which state they reside in.

For example, in thirty-two states and the District of Columbia, individuals who are eligible for Supplemental Security Income (SSI) are also eligible for Medicaid. The application for SSI serves as the application for Medicaid. As a result, resident in these states will automatically receive Medicaid coverage with SSI eligibility.

However, the following states require a separate application for Medicaid, although these states use the same eligibility criteria that the Social Security Administration (SSA) uses for SSI eligibility: Alaska, Idaho, Kansas, Nebraska, Nevada, Oregon, Utah, and the Northern Mariana Islands. As a result, in addition to applying for SSI, residents of these states will need to file a separate application for Medicaid, typically through the health insurance marketplace or through the state’s Medicaid agency.

On the other hand, some states apply their own criteria for Medicaid eligibility. These criteria differ from those used by the SSA. Such criteria may include: household size, household income, assets, age, and medical need. Residents of Connecticut, Hawaii, Illinois, Indiana, Minnesota, Missouri, New Hampshire, North Dakota, Ohio, Oklahoma, and Virginia must file an application for Medicaid separate from their application for SSI.

If you or someone you know is struggling with increasing medical costs due to an ongoing disability, please contact us today for a free case evaluation!

By: Nicole Hayes of Premier Disability Services, LLC^®