Disability & Medicaid Eligibility

Following employer-based coverage and Medicare, the Medicaid program is the third largest source of health insurance in the United States.

As the largest program in the federal “safety net” of public assistance programs, Medicaid provides essential medical and medically-related services to the most vulnerable populations in society. The Medicaid program covers millions of low-income women, children, elderly people and individuals with disabilities.

Applying for these programs can be complicated.  There are eligibility requirements that must be met; look back periods; dual-eligibility with Medicare and Medicaid; share of cost; medically needy; children and the elderly; waivers, nursing home and disability.  While the internet is a helpful place to start the process, having a professional by your side ensures that your are compliant from the beginning.

The same can be said for long-term disability. Disability is something most people do not like to think about. But, the chances that you will become disabled probably are greater than you realize. According to the Social Security Administration, studies show that a 20-year-old worker has a 3-in-10 chance of becoming disabled before reaching full retirement age.

Disability benefits are paid through two programs:

  • The Social Security Disability Insurance program (SSDI)
  • The Supplemental Security Income (SSI) program

Knowing which one you qualify for and to seek for your needs is also complicated. Statistically, initial claims have a denial rate of 65%. The first step of an appeal, called a “reconsideration” is typically denied at an even higher rate of up to 85%.

Getting the right information for your particular situation is crucial to a successful application process.

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