Click below for a listing of eligibility requirements and services offered by the following Social Security programs: Medicaid Supplemental Security Income Social Security Disability Insurance Social Security Checklist “Medicaid is a federal funding system which is administered in New Jersey by the Division of Medical Assistance & Health Services (DMAHS). Medicaid pays for a wide array of services for people with disabilities and their families and provides government-funded health insurance, including prescription coverage and personal care services, for children and adults with disabilities who have limited financial resources. Medicaid also provides government funding for long-term services and supports, including institutional care, and, increasingly, community based services such as group homes and self-directed services. These community-based services are funded through a “”waiver”” known as the Community Care Waiver (CCW). In New Jersey, the CCW is the primary funding source foradult services through DDD. The CCW allows the state to use federal and state funding for flexible services that are more person-centered. The CCW is for individuals with developmental disabilities who would otherwise require an institutional level of care, but who can be served at home. The CCW funds case management, respite care, habilitation (including pre-vocational, educational, and supported employment services), home and vehicle accessibility adaptations, personal emergency response systems, therapies, and other individual supports. ” Even if a person has private health insurance, Medicaid may pay for services that most private insurance plans do not cover such as private duty nursing, medical supplies, or even residential placement. In order to maximize federal funding, DDD requires all participants to maintain Medicaid eligibility. Eligibility for Medicaid is based on assessment of both disability and financial resources. Most adults who are DDD-eligible will meet the Medicaid definition of disability. Medicaid has stringent asset and earnings guidelines. Generally, Medicaid eligibility depends upon a person’s satisfying the requirements for the federal Supplemental Security Income (SSI) program. Medicaid “waivers” permitting higher monthly earnings may apply in some circumstances. With the exception of these waiver programs, the income and resources of parents of children under age 18 are considered. Once eligible for Medicaid, a person must receive services and cannot be placed on a waiting list. Under Medicaid regulations, a state cannot limit access to covered medical services simply because the cost of service exceeds the state budget. In New Jersey, certain “waiver” programs limit the number of participants. Once eligible for Medicaid services, no waiting lists for services are allowed. If an individual acquires assets or resources, such as in the case of inheritance or earnings, they may become ineligible and be required to reimburse Medicaid. “Back to top
” The SSI program makes cash assistance payments to aged, blind and disabled people (including children under age 18) who have limited income and resources. No work history is required to receive SSI benefits. There is also no waiting period. An individual may receive benefits as of the first day of the month following the month of application. The SSI benefit usually ranges between $400 and $600 per month. A person who qualifies for SSI also will qualify for Medicaid. In most cases, to qualify for SSI a person with a disability can have no more than approximately $700 to $800 in monthly income and no more than $2,000 in countable resources. Countable resources are the person’s property (other than certain exempt resources, such as the house one lives in and one car). The person also must have a disability that prevents gainful employment. When the person is under age 18 and living at home, family income and resources will be counted. However, once the applicant turns 18, family resources will not be counted even if the applicant continues living at home. What then matters is only the income and resources of the person. For this reason, most people with disabilities qualify for the first time at age 18. There are waivers and work incentive programs that allow an individual to remain on SSI and Medicaid and still have earnings in excess of the minimum monthly allowable requirements. Families should inquire directly with SSI and Medicaid about these programs. For information on Social Security Work Incentive Programs, contact NJWINS. “Back to top
” SSDI provides benefits to aged, disabled or blind individuals who are “insured” by workers’ contributions to the Social Security trust fund. These contributions are the Federal Insurance Contributions Act (FICA) Social Security tax paid on their earnings or those of their spouses or parents. As with SSI above, individuals can have no more than approximately $700 to $800 in monthly income and no more than $2,000 in countable resources. If an individual is eligible for SSDI benefits, they will also receive Medicare coverage; however, the first 24 months of disability benefit entitlement is the waiting period for Medicare coverage. Individuals who are aged, blind or disabled who have worked and paid Social Security taxes for enough years to be covered under Social Security insurance are eligible to receive SSDI. Some of the taxes must have been paid in recent years and the individual must be the worker, the worker’s widow(er) or the worker’s disabled adult child. The disabled child must be unmarried, age 18 or over, and his/her disability must have begun before the age of 22. “Back to top
” For more information, please visit the Social Security website.