Planning Around Government Assistance Programs

So you have just found out that your child has special needs. You know that there are programs out there for your child, but you are not sure where to start. You may wonder what the government provides, what it will cost you and how you are going to sort through all the information. A special needs planner with a benefits department will bring clarity to a very complex system.

Knowing what assistance your child qualifies for will make a difference in the type of care your child will receive now and in his adult years. A special needs planner will help you to assess your situation and clarify options. She will refer you to her benefits department, who will act as your liaison, utilizing their experience to effectively navigate through the system.

Your biggest resource for funding for your child will come from government assistance programs. The types of government assistance and your child’s eligibility for these programs can be very confusing. Let’s break down the types of assistance into four general categories:

Entitlements:

We are entitled to SSDI/SSA and Medicare because we bought these benefits by having money taken out of our paychecks throughout our working years.

Needs-Based:

SSI and Medicaid are available regardless of whether or not you paid into the system. Because these benefits are not purchased, the eligibility requirements are based on your income level and your assets.

Cash:

SSDI, SSA and SSI are all programs that provide cash to meet daily living expenses and to supplement any other benefits. Each have their own eligibility requirements.

Goods and Services:

These benefits come in the form of medical and residential assistance. These services are vital to your child’s future as an adult. The programs include Medicare and Medicaid.

 

PhotosToGoUnlimited-882886Now, let’s look at each program individually:

Social Security Disability (SSDI) and Social Security Administration (SSA):

When a working person becomes disabled, he or she will receive disability based on how much they have paid into the system and if they are substantially and gainfully employed. This is called the “income rule.” SSA is your retirement pay, which can be taken as early as age 62. It is important that you always save your social security statements for review. They tell you a lot about not only your own benefits, but what your family receives when you die.

Medicare:

Medicare begins two years after Social Security recognizes your disability. Medicare does not pay for prescriptions unless you have Medicare Part D. This benefit also follows the income rule when determining eligibility. That amount changes from year to year, and your special needs planner will help you to determine what that amount is so that your child will not be disqualified from other benefits.

Supplemental Security Income (SSI):

This program is for those who are not entitled to the benefit but need it. This benefit is subject to both the income rule and the asset rule. The current accepted assets that you can have are your house, a car, a prepaid funeral and $2000. If the person receiving benefits exceeds this by any amount, they are disqualified from receiving benefits. A special needs planner will help you put strategies in place to help your child qualify for these benefits.

Medicaid:

Medicaid typically goes with SSI. As with SSI, Medicaid is subject to the income and asset rules. You can have both health insurance and Medicaid. Medicaid pays for deductibles and co-pays that your health insurance does not cover. But the most beneficial reason for your child to qualify for Medicaid is to gain access to funding which will provide for your child’s programs, workshops and residential housing.

A special needs planner and her benefits department can also help you through the complicated application process. They can provide information about the proof you will need to show your child is disabled. Your special needs planner can help you through the questions they will ask and guide you through your visit to the social security office. Her benefits department may also act as your representative for your child.

Helping you obtain benefits for your child is where a special needs planner will be most valuable. She will be able to interpret your social security statement and let you know what your child can qualify for. She will be able to help you through the application process, and she will be familiar with the programs available in your state. Finally, she will be able to keep up with the law changes and new programs as they come along. She will bring order to the chaos. You shouldn’t have to navigate this maze alone.

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