Skip Navigation
Done

Disability Benefits

Disability benefits in a nutshell

 Please note this is a VERY general overview & available benefits are always evaluated on a case-by-case basis for each applicant.

 

With a diagnosis of ALS am I eligible for disability?

Yes: If you have been diagnosed with ALS you should qualify for Social Security disability benefits as ALS is considered a presumptive disability. The applicant must meet specific criteria but most PALS meet these. You do have to stop working to apply for disability benefits. You can be using short or long term disability benefits though.

Disability benefits include: Medicare & SSDI. Medicaid & SSI.

Medicare & Medicaid are social health insurance programs. SSDI & SSI are financial benefits.

Medicaid is not the same as Medicare. SSI & SSDI are not the same either.

Medicare & Medicaid: the health insurance benefits:

Medicare:  is a federal program that provides health coverage earlier than retirement age if you have a severe disability. You must be a qualified worker. Typically this means you have paid into the social security system for at least ten years. You likely are eligible for SSDI benefits also.

Medicaid:  is a state and federal program that provides health coverage if you have a very low income. You likely are eligible for SSI benefits also.

  • Note: If you are eligible for both Medicare & Medicaid, you can have both & they will provide you with very good health coverage.

The disability benefits (monthly $$):

 Social Security disability insurance (SSDI, associated with Medicare qualified PALS): is typically available to any person who has paid into the Social Security system for at least ten years (qualified workers). The Medicare health insurance benefit that is associated with SSDI, has a 5 month waiting period. This starts from the date you are DEEMED disabled. This is often the date you were diagnosed with the disease. SSDI monetary benefits may be retroactive to your disability date but check with your disability contact person.

SSDI Provides Access to Medicare health insurance

 

Social Security insurance (SSI, associated with Medicaid qualified PALS): is funded by general tax revenues, not by taxes taken from individual workers’ paychecks. SSI has very strict financial requirements. These benefits typically are retroactive to the date you are DEEMED disabled as well, but check with your disability contact person.

SSI Beneficiaries Typically Receive Medicaid

·        Note: Typically the dependent children of recipients of SSI & SSDI are eligible for some benefits also.

PALS should also have expedited approvals for your disability claim. This is called a TERI case & should always be mentioned while you are applying.

  

To apply for disability benefits, call the Social Security Administration’s at (800) 772-1213, online at www.ssa.gov, or visit your local Social Security office.

Medicare eligible PALS, there are different parts you need to be aware of:

Very briefly:

A= hospital insurance (free)

B= medical/outpatient insurance ($ premium)

D= pharmacy/medication, insurance ($ premium)

C= not a separate benefit, but a policy that allows private health insurance companies to provide Medicare benefits known as Medicare Advantage Plans.  These are NOT supplemental plans but replace original/regular Medicare.

Luckily there is free help navigating this complicated system!!

One resource is www.mygeorgiacares.org provides resources including the state SHIP program (state health insurance assistance program) that will provide free one on one counseling & explain all of your options regarding Medicare & many other issues. They can be reached at (800) 669-8387 or online at

http://www.mygeorgiacares.org/OutreachandEducation/StateHealthInsuranceAssistanceProgram%28SHIP%29.aspx

Done