With a spinal cord injury, you think it’d be easy to qualify for health insurance, but with federal medical insurance programs, it’s not an open and shut case like you’d think. The state you live in has a major effect on what you can receive. Unlike Medicare, half of Medicaid is funded by the state (versus Medicare being 100% funded by the federal government).
Because of this, states across the country provide drastically different versions of Medicaid. Some states won’t pay for personal care attendants , which is a cornerstone of many people’s independence. Before you leave the hospital (if you know you will be needing it), you’ll want to apply. It can take three or four months as well to be approved.
Do you qualify?
The short answer is yes, if you don’t make over the income limit that is (the income limit varies state-by-state). With a spinal cord injury, this is considered a significant disability so you are eligible for what is called “Long-term care” Medicaid. You can easily reapply each year when you have this version of Medicaid too.
In 2014, the Federal government did do something very exciting – they allowed states to expand their Medicaid program (only 25 agreed, 21 states declined). Check out our link below to see where your state stands. There’s also a direct link below to see if you are eligible.
How to Apply
When you apply for Medicaid, you need to show proof for all of your monthly income and all of your assets. This is unfortunately one of the hardest parts of the process, but it is a requirement since this health insurance program was designed for both the poor and disabled. If you decide to go back to work or want to get a job, you will need to see if you will lose your benefits. As we said above, the rules greatly depends on the state you live in.
There are even some states that offer a version of Medicaid called MAEPD, which is a version of Medicaid that allows you to work fulltime and still receive Medicaid. This is great for quadriplegics who require personal care attendant to get out of bed each morning but still want to go to work. Beware however, there can be a waiting list for this program in many states.
Often times the easiest way to apply to Medicaid is by becoming SSI eligible. In 41 states, D.C, and the Northern Mariana Islands, if a person gets any SSI cash payment Medicaid eligibility is automatic. The majority of the states automatically enroll a person in Medicaid through its own internal SSI eligibility notification process but some state require that a person also submit an application to be automatically approved. It is important to note that the Medicaid a person receives is unique to the state they live in.
To apply for Medicaid in the easiest way possible, check out the link below to apply online. You’ll still need to mail in a paper version of the application and provide proof of your monthly income and your assets, but this can be mailed your home. Otherwise, go to your local Social Security Office and pick up an application in-person. Remember, it can take 3 to 4 months for your application to be processed.
Please review the following video on how to successfully apply for Medicaid, and then read the Takeaway Points below.
Video: Medicaid
Takeaway Points:
- Medicaid provides medical care to those in need
- You can apply for disability benefits, including Medicaid, at local Social Security office
- Poor, blind or disabled can apply for Medicaid
- There may be a Residency Requirement. You’ll want to check with your state to see the rules
- When applying for Medicaid, your assets & income will be looked at
- MAEPD allows people with spinal cord injuries to still receive Medicaid Services while working full time, as long as they pay each month
- States have to pay for half the costs, hence the differences in Medicaid between states
Helpful Resources:
- Health Insurance – Reeve Foundation – http://www.christopherreeve.org/site/c.mtKZKgMWKwG/b.4514609/k.A34F/Health_Insurance.htm
- Individuals with Disabilities – Medicaid.gov – http://www.medicaid.gov/medicaid-chip-program-information/by-population/people-with-disabilities/individuals-with-disabilities.html
- Supplemental Security Income (SSI) Disability & Medicaid coverage – Healthcare.gov – https://www.healthcare.gov/people-with-disabilities/ssi-and-medicaid/
- Apply for Medicaid online https://www.healthcare.gov/medicaid-chip/
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