Helping You Live Independently

If you are struggling to live on your own with a disability or care for a relative who is disabled, the Affordable Care Act may help. The law expanded Medicaid programs that provide in-home care and help you avoid moving to a nursing home. The expansion of Medicaids Home and Community-Based Service options can help you stay independent or provide care for a loved one. In general, these services are only available to people who qualify for Medicaid.

Applying For Apple Health Coverage

• Online: Visit washingtonconnection.org.
• Paper application:. Mail the form to the Washington State Department of Social and Health Services : DSHS Community Services Division, P.O. Box 11699, Tacoma, WA 98411-6699.
• In person: Visit a Community Services Office near you. Visit the DSHS site for locations.
• Phone: Call DSHS at 1-877-501-2233.

Can You Do Any Other Type Of Work

If you cant do the work you did in the past, we look to see if there is other work you could do despite your medical impairment.

We consider your medical conditions, age, education, past work experience, and any transferable skills you may have. If you cant do other work, well decide you qualify for disability benefits. If you can do other work, well decide that you dont have a qualifying disability and your claim will be denied.

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Adults With A Disability That Began Before Age 22

An adult who has a disability that began before age 22 may be eligible for benefits if their parent is deceased or starts receiving retirement or disability benefits. We consider this a “child’s” benefit because it is paid on a parent’s Social Security earnings record.

The Disabled Adult Child who may be an adopted child, or, in some cases, a stepchild, grandchild, or step grandchild must be unmarried, age 18 or older, have a qualified disability that started before age 22, and meet the definition of disability for adults.

Example

It is not necessary that the DAC ever worked. Benefits are paid based on the parent’s earnings record.

• A DAC must not have substantial earnings. The amount of earnings we consider substantial increases each year. In 2022, this means working and earning more than $1,350 a month.

Working While Disabled: How We Can Help

I Need Or Get Help With Costs

If you have limited income and resources, you may qualify for help to pay for some health care and drug coverage costs.

• Get help with Part A and Part B costs If you qualify for this help or Medicaid, youll automatically qualify for Extra Help to lower your Medicare Part D drug costs.
• Get details on cost saving programs Find out if your state or the drug company offers help to lower drug costs, and see if you may qualify for Extra Help.
• Apply for Extra Help .

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Types Of Health Insurance Plans

When purchasing health insurance, your choices typically fall into one of three categories:

• Traditional fee-for-service health insurance plans are usually the most expensive choice. They offer the most flexibility in choosing health care providers.
• Health maintenance organizations offer lower co-payments and cover the costs of more preventive care. Your choice of health care providers is limited to those who are part of the plan.
• Preferred provider organizations offer lower co-payments like HMOs but give you more options when selecting a provider.

Information You Need To Apply

Before applying, be ready to provide information about yourself, your medical condition, and your work. We recommend you print and review the . It will help you gather the information you need to complete the application.

Information About You

• Your date and place of birth and Social Security number.
• The name, Social Security number, and date of birth or age of your current spouse and any former spouse. You should also know the dates and places of marriage and dates of divorce or death .
• Names and dates of birth of children not yet 18 years of age.
• Your bank or other and the account number.

Information About Your Medical Condition

• Name, address, and phone number of someone we can contact who knows about your medical conditions and can help with your application.
• Detailed information about your medical illnesses, injuries, or conditions:
• Names, addresses, phone numbers, patient ID numbers, and dates of treatment for all doctors, hospitals, and clinics.
• Names of medicines, the amount you are taking, and who prescribed them.
• Names and dates of medical tests you have had and who ordered them.

Information About Your Work:

• Award letters, pay stubs, settlement agreements, or other .

We accept photocopies of W-2 forms, self-employment tax returns, and medical documents, but we must see the originals of most other documents, such as your birth certificate.

Do not delay applying for benefits because you do not have all the documents. We will help you get them.

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Apply For Medicaid Or A Private Health Plan Through The Marketplace

• When you fill out your Marketplace application, answer âyesâ when asked if you have a disability. Weâll forward your application to your state Medicaid agency. If you qualify, theyâll help you enroll.
• You can also apply for Medicaid coverage directly through your state agency. Select your state from the menu on this Medicaid page for contact information.

Who Is Eligible For Di Benefits

The Social Security test of disability is very strict. To be eligible for disability benefits, the Social Security law says that the applicant must be unable to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or is expected to last for a continuous period of at least 12 months. Furthermore, the impairment or combination of impairments must be of such severity that the applicant is not only unable to do his or her previous work but cannot, considering his or her age, education, and work experience, engage in any other kind of substantial gainful work which exists in the national economy ).

A person is considered to be involved in substantial gainful activity if he or she earns more than a certain amount. If a non-blind individual earns more than $1,170 a month in 2017, he or she would not be eligible for disabled worker benefits. The amount is adjusted each year to keep up with average wages. The substantial gainful activity level for blind individuals in 2017 is $1,950 a month.

State agencies, operating under federal guidelines, make the medical and vocational determinations for the Social Security Administration about whether applicants meet the test of disability in the law. Medical records, work history, and the applicants age and education are considered in making the determination.

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How To Get Health Coverage

You can get health care coverage through:

• A group coverage plan at your job or your spouse or partner’s job
• Your parents’ insurance plan, if you are under age 26
• A plan you purchase on your own directly from a health insurance company or through the Health Insurance Marketplace
• Government programs such as

If You Get Extra Help With Medicare Drug Costs:

Well mail you a letter telling you the level of help youll get. If you dont have or dont join a Medicare drug plan, well put you in one so you can fill your prescriptions at the discounted cost.

If you dont like that plan, you can switch to a different one. There are even plans just for people with both Medicare and Medicaid.

• Check when you can join or switch plans You have more chances to join or switch plans if you have Medicaid, get Extra Help, or your state helps lower your drug costs.
• Review all letters we mail to people with Extra Help.

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Choosing A Health Insurance Plan

Reading the fine print is important when choosing health care plans. These questions may help:

• Can I go to any doctor, hospital, clinic, or pharmacy I choose?
• Are specialists, such as eye doctors and dentists covered?
• Does the plan cover special conditions or treatments such as pregnancy, psychiatric care, and physical therapy?
• Does the plan cover home care or nursing home care?
• Will the plan cover all medications my physician may prescribe?
• What are the deductibles? This is the amount you must pay each year before your insurance company will begin paying claims.
• Are there any co-payments? This is the amount of money you pay each time you receive medical services or a prescription.
• If there is a dispute about a bill or service, how is it handled?

Health Insurance For People With Disabilities

Updated on Friday, August 17 2018 | 0 min. read| by Bryan Ochalla

If you have a disability, having good health insurance is a must. Find out what insurance covers disabilities, and how you can get covered.

One in eight Americans have a disability according to the most recent data from the U.S. Census Bureau. A 2015 study by the CDC found the same to be true of one out of every five adults in the U.S.

If you’re one of the 40 million or so Americans with disabilities, you know first-hand how important good healthcare is. Perhaps you’re wondering where and how you can get great health insurance.

Well, youve come to the right place. Youll find answers to that question and many others in this article.

Keep reading even if you dont currently have a disability. The Social Security Administration says one in four 20-year-olds will become disabled by age 67.

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Option : Buy Through A Membership Organization

If you belong to a union, alumni association, professional organization, or any other large group, you may be able to purchase health insurance through it at group rates. Freelancers Union, for example, offers health insurance through its subsidiary, Freelancers Insurance Agency, and through one of its partners, HealthPlanServices.

When looking for health insurance through an association or membership organization, make sure you will actually be purchasing insurance and not just a health services discount plan. Discount plans might save you money on prescriptions or eyeglasses, but they wont help you if you get cancer. Also be aware that even if the association itself is a not-for-profit organization, it may be tied to or even established by a for-profit insurance agency through which it sells policies to association members.

How Do I Get Health Insurance If I Have A Disability

If you have a terminal illness, need daily assistance with care at home or in a group setting, live in a long-term care or group home, have a disability, or have a condition that limits your employment, there are options available. Disabilities are covered under pre-existing health conditions, and plans cannot charge you more due to your health circumstances before coverage.

With Social Security Disability Income , you can apply for coverage through Medicaid. Most states automatically grant Medicaid when you get approved for SSI based on disability, although in some states, SSI does not guarantee Medicaid. It pays to check your state’s rules. In some states, SSI guarantees eligibility, but separate registration is still necessary.

If you have Social Security Disability Insurance , you can apply for coverage through Medicare.

Unfortunately, you cannot supplement or change your insurance to a Marketplace plan if you have Medicare already. If you are enrolled in a Marketplace plan prior to your Medicare application, you can keep it as supplement insurancebut you will forfeit any premium tax credits and additional savings offered.

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Is Your Condition Severe

Your condition must significantly limit your ability to do basic work-related activities, such as lifting, standing, walking, sitting, or remembering for at least 12 months. If it does not, we will find that you do not have a qualifying disability.

If your condition does interfere with basic work-related activities, we go to Step 3.

How Do I Get Health Insurance If I Am Self

If you own your own business, you can apply for health coverage through the Marketplace. Your income and household size may qualify you for premium tax credits and other insurance savings. There could also be free or low-cost coverage through CHIP or Medicaid programs in your state. Marketplace plans allow business owners to insure their children and spouses. Healthcare savings are based on an estimate of net earnings in the year you apply, not the previous years income.

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Disability Insurance Through Your Employer

Voluntary benefit offerings are the fastest growing approach to providing short- and long-term disability insurance through the workplace, says Harnett. Employees can purchase short- and/or or long-term disability coverage through voluntary offerings, she explains. The employee pays all of the premium when they enroll in voluntary benefits.

There are two advantages of voluntary coverage:

• If an employee files a claim for disability benefits, they are not taxable since the employee paid the premium.
• If the employee leaves the company, they can take the coverage with them .

What Is The Best Type Of Disability Insurance

The best type of disability insurance is the one that best meets your personal needs. Policies are offered to individuals or as group plans through an employer. Coverage options are either short- or long-term, and both are valuable depending on whether your illness or injury is temporary or not.

If you already have a group long-term policy through your workplace, it might be wise to add supplemental or individual short-term coverage on your own. This will help bridge the gap between when your disability occurs and when your existing coverage kicks in and also may offer other benefits such as student loan repayment protection.

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Unitedhealthcare Senior Care Options Plan

UnitedHealthcare SCO is a Coordinated Care plan with a Medicare contract and a contract with the Commonwealth of Massachusetts Medicaid program. Enrollment in the plan depends on the plans contract renewal with Medicare. This plan is a voluntary program that is available to anyone 65 and older who qualifies for MassHealth Standard and Original Medicare. If you have MassHealth Standard, but you do not qualify for Original Medicare, you may still be eligible to enroll in our MassHealth Senior Care Option plan and receive all of your MassHealth benefits through our SCO program.

How We Chose The Best Disability Insurance

We compared more than 15 disability insurers before picking the best for each category. In doing so, we compared the products offered, pricing, the ease of getting a quote and then buying coverage, options for benefits, and how quickly coverage would kick in.

Of course, it also was important to choose insurers with a strong history of claims satisfaction, trusted coverage, and financial stability. We looked at data from the NAIC and AM Best in that analysis.

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Business Overhead Expense Disability Insurance

Business Overhead Expense coverage reimburses a business for overhead expenses should the owner experience a disability. Eligible benefits include: rent or mortgage payments, utilities, leasing costs, laundry/maintenance, accounting/billing and collection service fees, business insurance premiums, employee salaries, employee benefits, property tax, and other regular monthly expenses.

Benefits For Children With Disabilities

A child under age 18 may have a disability, but we don’t need to consider the child’s disability when deciding if he or she qualifies for benefits as a dependent. The child’s benefits normally stop at age 18 unless they are a full-time student in an elementary or high school or have a qualifying disability.

Children who were receiving benefits as a minor child on a parents Social Security record may be eligible to continue receiving benefits on that parents record upon reaching age 18 if they have a qualifying disability.

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If You Enlisted After September 7 1980 Or Entered Active Duty After October 16 1981

You must have served 24 continuous months or the full period for which you were called to active duty, unless any of the descriptions below are true for you.

This minimum duty requirement may not apply if any of these are true:

• You were discharged for a disability that was causedor made worseby your active-duty service, or
• You were discharged for a hardship or early out,or
• You served prior to September 7, 1980

Employer Canceling Health Insurance While On Disability

The first thing that might happen to your health insurance when you go on disability is that your employer might cancel the coverage when they terminate your employment.

The Family Medical Leave Act requires employers to maintain group health coverage as if disabled employees are still working. But it covers only about half of all workers and lasts only twelve weeks. However, do not worry, as you have three options to address the issue.

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