When determining patients’ eligibility for financial assistance with healthcare costs, DECO Recovery Management looks into many different options. Two such options are programs provided by the Social Security Administration: Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI). These are two similar programs with different goals, so it’s easy to get them mixed up. Here’s what sets them apart from one another.
What is Disability?
The SSA defines disability as “the inability to engage in any substantial gainful activity (SGA) by reason of any medically determinable physical or mental impairment(s) which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months.” In essence, disability is the state of an individual in which, as a result of a chronic or severe physical or mental incapacity, they will not be able to work for an extended period of time and will therefore need assistance providing for their basic necessities. SSI and SSDI exist to support those with disabilities and help alleviate their financial needs. These programs also provide the potential to be eligible for government-sponsored healthcare.
Social Security Disability Insurance is a program set up for people under the age of 65 who have a previous work history. As a result of their disability, however, they cannot continue working to retirement age. Their eligibility is determined based on a system of work credits, or proof that they have fulfilled SGA requirements, over the course of about 5 to 10 years, and what kind of disability they have. People who qualify for SSDI can become eligible for Medicare after 24 months of receiving benefits. However, because there is a waiting period of at least five or six months between qualifying for SSDI and beginning to receive benefits, it may be upwards of 29-30 months total before the individual with a disability can start using Medicare. One other benefit, however, is that an individual who receives SSDI benefits may also enable his or her direct family members to receive auxiliary benefits, as well.
Supplemental Security Income is a program set up to provide assistance for individuals with disabilities, regardless of age, who have severely limited income, assets and resources. It is a strictly “need-based program”. The income paid to these individuals is just what the name implies: supplemental, and based on whatever limited income they already receive. Work credits are not required for this program. SSI recipients usually receive much lower supplemental funds than SSDI recipients, but they begin receiving aid much more quickly, a minimum of a month after they qualify. Recipients of SSI are also often eligible to receive SNAP and Medicaid benefits.
How DECO Can Help
Having a patient who is eligible for SSDI and/or SSI can be helpful for healthcare organizations. These individuals are more likely to be insured, which means there’s less to worry about regarding compensation. At DECO, we help make the eligibility process as smooth as possible so that your healthcare organization can have a steady and reliable revenue stream. Our compassionate and professional eligibility experts engage with patients, obtain their information and do what needs to be done to get them the financial assistance they need. If you need help with revenue cycle management, or if you have any other questions regarding eligibility, contact us today!