Living life with a disability can often be tough. But if you or a loved one is afflicted with a disability, know that you don’t have to struggle on your own to make ends meet. The government provides aid to those with disabilities in various ways. The four largest and most common forms of government aid are Social Security, Supplemental Security Income, Medicare and Medicaid.
Two forms of aid, Supplemental Security Income, or “SSI”, and Medicaid, are known as “need-based” assistance. This means that aid is offered, generally, to lower-income applicants only. Alternatively, Social Security and Medicare benefits are “employment-based,” or benefits available to an applicant based upon their own, or a close relative’s, work history. Each is uniquely different and possesses different standards for qualification. Therefore, recognizing these differences becomes key to knowing for which program to apply. We offer a general overview of each program below:
1) Supplemental Security Income
SSI is a government assistance program for US citizens or nationals (and some non-citizens) living in the U.S. or the Northern Mariana Islands. To be eligible, the applicant must be age 65 or older, or, regardless of age, he or she must be blind or disabled. The applicant need not be completely blind to qualify, and to meet the criteria of being “disabled,” a physical or mental difficulty must be expected to prevent the applicant from working for at least one year or result in death. Additionally, vocational rehabilitation services must be accepted if available.
The amount of assistance one may qualify for, or determining if one qualifies at all, is dependent upon the area in which the applicant lives, as well as upon his or her income and assets owned, in addition to that of the applicant’s spouse, or parents if under the age of 18.
Medicaid is another need-based government assistance program, offering medical benefits generally to the elderly, blind or disabled who meet restrictive state-specific standards, SSI recipients, and/or medically needy individuals who are unable to pay their medical bills. Medicaid is a joint state and federal program with state law determining which of the above categories qualify for Medicaid. This program generally helps pay for hospitalization, outpatient services, physician’s services, nursing home care and home health care, to name a only few covered services.
1) Social Security
Social Security provides qualified individuals with retirement benefits and disability benefits. However, to qualify for disability aid, the disability must be expected to prevent the applicant from working for at least a year or result in death, thereby disqualifying those with short-term / temporary disabilities. Additionally, the applicant must have worked long enough and recently enough to meet certain Social Security requirements. Disability benefits can be received until age 65, at which point, the benefits convert to retirement benefits in an equivalent amount.
Social Security is an employment-based government assistance program. Employees pay into the Social Security trust fund through payroll taxes, and benefits are available to employees and their dependants. The amount available as aid is based upon the applicant’s lifetime average earnings. Additionally, retirement benefits can be reduced based upon whether retirement is taken early or if excess income is earned during retirement. Payments will end if the recipient no longer is disabled or can work at a level considered “substantial” (generally, $700 or more in average monthly earnings).
Medicare is the second form of employment-based assistance. The government offers Medicare in two different parts – A and B. Medicare Part A – Hospital Insurance covers hospital bills, skilled nursing care up to 100 days, and other medically related follow-up care and is paid out of employment taxes. Therefore, no premiums are required.
To qualify, the applicant must be a U.S. citizen or permanent resident. If age 65 or older, qualification is based upon the applicant’s (or his or her spouse’s) employment. Alternatively, one may qualify for Medicare Part A if he or she receives (or is eligible to receive) Social Security or railroad retirement benefits. If the applicant (or his or her spouse) worked in a government job where Medicare taxes were paid they will also qualify for Medicare Part A.
If, however, the applicant is under age 65, qualification is still possible under the following circumstances: (1) after being entitled to receive Social Security for 24 months, (2) receiving a disability annuity from a railroad, (3) after qualifying for Social Security disability and where the applicant or a parent or spouse has worked at a government job at which they have paid Medicare taxes, or (4) where the applicant has permanent kidney failure (other requirements apply).
The second form of Medicare is called Medicare Part B – Medical Insurance. Part B covers expenses such as physician’s bills. Differing greatly from Medicare Part A is that Medicare Part B requires the payment of premiums. However, some states will pay the premiums or deductibles of low-income applicants with few resources depending upon state law.
To qualify for Medicare Part B, the applicant must be eligible for Medicare hospital insurance or if ineligible, must be a U.S. citizen or lawfully admitted alien who has lived in the U.S. for a minimum of 5 years, and age 65 or older.
ASSISTANCE FROM A QUALIFIED ATTORNEY
The assortment of requirements necessary to qualify for the various forms of aid available to a disabled loved one can be overwhelming. To add to the complexity, certain asset transfers may disqualify you from qualifying for need-based assistance. Therefore, it is imperative that you consult with a qualified estate planning attorney who is familiar with the technical rules in this complicated arena. Failing to do so could mean losing out on valuable government assistance.
Mr. Ronald “Chip” Morrison, Jr. is a Board-Certified Specialist in Estate Planning and Administration by Louisiana Board of Legal Specialization and a member of the American Academy of Estate Planning Attorneys. He has experience in both simple and complex estate matters and has helped thousands of clients throughout southern Louisiana. For more information or to attend an upcoming seminar, please call our office at (504) 831-2348 or contact us through our website.