Obtaining and preserving government benefits such as Supplemental Security Income and Medicaid is often critical for special needs families. These programs can provide income and support when it is most needed, access to medical care and therapies, as well as housing. Yet these programs each have their own set of regulations and qualification criteria. Understanding how these programs interplay with each other, and how they change as the beneficiary ages, is an imperative when planning for a special needs loved one. While these programs provided critically important benefits; they can also be negatively impacted if the disabled person inherits money or other resources. As part of our lifetime oriented planning we look at many of these programs, how they relate to your family’s specific situation, and offer guidance accordingly.
Supplemental Security Income (“SSI”) is a program that provides a modest level of income for a disabled person meeting certain criteria. SSI is a “means tested” program. Therefore to qualify the beneficiary must meet certain income and resource restrictions. In many cases a parent’s income is “deemed” to be available to a child under 18. However, once the child turns 19 the “deeming” ends making the child potentially eligible. In certain circumstances SSI is available even for disabled children under 19.
SSI is important to special needs families. It provides a set income that can help pay numerous living expenses. Perhaps more importantly, an SSI recipient in Arkansas is automatically qualified for Medicaid. Yet it is impacted by a number of variables. The deeming regarding a parent’s income changes as the child ages. And benefits may be reduced if the beneficiary earns income or continues to live with his or her parents after 18.
At Thomas Smith Law Firm we will work to make sure you understand how SSI works, its importance to your special needs loved one, and how changes in your family scenario will affect benefits.
One of, if not the most, important government benefit for special needs families is Medicaid. This program provides medical care for persons who meet certain income restrictions, are aged, or disabled. Medicaid is especially important because it provides a way of obtaining medical care that might not otherwise be affordable or available through traditional health insurance programs.
Like many government benefits; Medicaid is a means tested program. When qualifying for Medicaid the beneficiary (or his or her parents) must meet certain income and resource criteria. One of the most common ways to qualify for Medicaid is to obtain SSI. Another common method for obtaining Medicaid is through the TEFRA program. This program is especially important for many younger families because it effectively allows them to “buy in” to the Medicaid program for their disabled children.
TEFRA (short for the Tax Equity Fiscal Responsibility Act of 1982) is a program for families with disabled children under 19 and receive care at home. Importantly this program is available to many families that have income and resources in excess of the Medicaid or SSI limits. Premiums are based on a sliding scale provided by the Arkansas Department of Human Services. Some lower income families pay nothing for TEFRA while higher income families pay premiums based on there income up to a certain cap.
TEFRA is a common benefit used by special needs families. However it’s important to remember that this benefit is only available until the child turns 19. TEFRA recipients in their late teens should have a clear plan of how they will maintain Medicaid of some other form of medical coverage after turning 19.
The programs listed above are just some of the benefits that may be available to persons with special needs. Others, such as waiver programs, are also important for families to consider as they plan for their loved one’s future. At Thomas Smith Law Firm we will work with you to develop a personalized lifetime oriented plan that integrates decision making authority, estate planning, and government benefit planning in a manner that best meets your family’s needs.