Medicaid vs Medicare

Let me start out by saying that whoever decided to call these programs Medicaid and Medicare has caused a lot of confusion and rightfully so.  People get Medicaid and Medicare mixed up constantly.  It would make this much simpler if they didn’t sound the same because they sure do not act the same.  The only thing they have in common is a health care program.   Medicaid is administered by the states for people with low incomes and limited resources.  Michigan allows children eligible for SSI to automatically be eligible for Medicaid benefits. Even if the child does not qualify for SSI, they could still qualify for Medicaid.  Visit www.michigan.gov/mdch for more information on programs available to children and families. 

Medicare is a federal program for people age 65 and older and for some people receiving Social Security disability benefits under the age of 65. 

It is possible to be eligible for both Medicare and Medicaid.  That’s a complicated topic and one that you should speak to Social Security about if you think your adult child is eligible for both.

Social Security Benefits for Children with Disabilities Part II

What happens when your child turns age 18?  Under Social Security benefits, the child becomes an adult and new rules apply.  The biggest change is that only the adult child’s income and resources are used in determining eligibility (not the other family members).  So individuals may qualify for SSDI as an adult child when they couldn’t qualify for SSI as a child.   The definition of disabled also shifts to the adult definition.  Disability under the Social Security definition means:

• “you cannot do work that you did before;
• We [Social Security] decide that you cannot adjust to other work because of your medical condition(s); and
• Your disability has lasted or is expected to last for at least one year or to result in death.” 
• www.ssa.gov/dibplan/dqualify4.htm

If an adult child was disabled before the age of 22, they may qualify for Social Security Disability Insurance (SSDI).  Social Security considers this a child’s benefit since it is paid on the parent’s Social Security earnings record.  If the parent has never worked, no benefits would be paid to the adult child.  The adult child can still work and receive SSDI, they just cannot have “substantial earnings.”  In 2011, Social Security defines that as earning more than $1000 per month. 

The application process is the same as it is for SSI benefits.  You can either call 800-772-1213 or visit your local Social Security office.  Because we are taking about disabled adult’s child benefits, you cannot apply online at this time.  That can be misleading because ordinarily, SSDI benefits can be applied for online.

Social Security Benefits for Children Part I

Supplemental Security Income (SSI) makes monthly payments to people with low income and limited resources, based on financial need.  Children under the age of 18 may qualify for SSI if certain requirements are met.  Here are some general guidelines in evaluating if your child or one you know of may be eligible for SSI.

• SSI is for children under the age of 18 (or under the age of 22 if regularly attending school)
• There is no minimum age requirement
• Criteria includes:
  • “medically determinable physical or mental impairment or impairments which result in marked and severe functional limitations; and
  • The condition(s) must have lasted or be expected to last for a continuous period of at least 12 months or be expected to result in death”
  • www.ssa.gov/ssi/text-child-ussi.htm
• Social Security has developed a Compassionate Allowance initiative to target and help those most obviously disabled.  A complete list can be found at www.ssa.gov/compassionateallowances
• Low Income and Limited Resources – SSI doesn’t just look at the child’s income and resources but his or her parents’ and/or family members within the household as well.  SSI annual limits for resources are $2000 for an individual or $3000 for a couple.  SSI has limits for income that can reduce the benefit amount as well.  www.ssa.gov/ssi has a list of income and resources excluded from the calculation to determine eligibility.

 If you think your child or one you know of meets these general guidelines, you should apply for SSI benefits.  At this time, Social Security does not have applications online.  You can either call 800-772-1213 or make an appointment at your local Social Security office.

SSI/SSDI

Happy 4th of July! I love this time of year. Probably because it entails time with family and friends, a road trip or two, and grilling out every night possible. And I still have child-like amazement every time I watch a firework show. This month I’m focusing on benefits for children with disabilities. I get asked all the time by families if they qualify for extra help. I am certainly no Social Security expert, but hopefully in the next couple weeks I can point you in the right direction. If you have a topic or question you’d like addressed this month, please email that to me at kbolker@sigmarep.com and I’m happy to add it in if I can. Topics will include SSI, SSDI, and Medicaid/Medicare.