Dealing with disability expenses can be a long, rough road to walk for any family. Because healthcare bills for a child with a disability can easily pile up, it can be challenging for the child’s parents to find a way to pay for them. Fortunately, many children with disabilities are eligible to receive assistance through the Social Security Administration, which can lead to receiving healthcare coverage through Medicaid.
SSI for Children
Supplemental Security Income (SSI) can be a major source of aid for children with disabilities. According to the eligibility criteria laid down by the Social Security Administration (SSA), a child may be able to receive SSI benefits if:
- They have sight impairments resulting in legal blindness
- They have a physical, intellectual or emotional disability like autism or Down Syndrome
- They have an impairment that has lasted (or is expected to last) at least 12 months, or that may be terminal
A child with a disability can receive SSI benefits as early as birth and up to the age of 18. Once they reach that age, they must be eligible under the SSI criteria for adults in order to continue receiving SSI benefits. The amount of income that the child with a disability will receive is based on the income of the child’s parents or legal guardians, since most children don’t have a major source of income.
Receiving SSI benefits also usually leads to eligibility for healthcare coverage through Medicaid. Since disability healthcare is costly, this is an advantage for all parties concerned: the healthcare organizations responsible for treatment, the child and the child’s parents.
SSDI for Children
Children cannot be eligible for Social Security Disability Insurance (SSDI) by themselves, because SSDI is a program for adults that requires a record of work credits. Only adults with disabilities who are under the age of 65 are eligible to receive SSDI. This is usually the result of the adult becoming disabled while working and becoming unable to work or hold a full-time job until retirement age.
However, this does not mean that children are completely counted out of receiving SSDI benefits. Children may be able to receive auxiliary benefits as an extension of their parent’s SSDI whether or not they themselves have a disability.
Disability and Medicaid
Children’s healthcare needs and requirements are different from those of adults. Oftentimes, a child with a disability may be eligible for Medicaid whether they receive SSI benefits or not. These regulations are dependent on the state in which they live, as Medicaid is a federal program that each state implements differently. Where a family might be required to make less than 138 percent of the federal poverty level (FPL), a child might be eligible for Medicaid if the family’s income is above that (often 150-200 percent of the FPL). Assuming the child meets the Social Security Administration’s criteria for disability, they might be immediately eligible for Medicaid, even if only as a secondary payment method.
Healthcare Organizations and Disability
Healthcare costs for disability treatment, whether the individual with a disability is a child or an adult, are expensive and can be difficult for even the most well-prepared and financially stable family to pay. That’s why it can be such a reassurance to healthcare organizations when a child with a disability receives SSI and is covered by Medicaid.
At DECO, our goal is to foster a good revenue cycle management system for healthcare organizations and help patients find ways to pay their bills. If your patients have disabilities, we can help them through the process of becoming able to receive disability benefits so that all parties can rest assured that the bills are being paid. If your organization needs help understanding eligibility or working with patients through this process, we’re here to help. Contact us today!