| |
SSI |
SSDI |
| Also
Known As |
Supplemental
Security Income |
Social Security
Disability Insurance |
| Eligibility
Criteria |
•
Needs based—must have little or no income and resources |
•
Insured status as a worker, or a child, widow, or widower of an insured
worker
• No resource limits, no limits on unearned income |
| Monthly
Benefit Amounts |
• Designed to bring income up to Federal Benefit Rate (FBR) of
$674 (2009)
•
Check amount depends on:
a) living situation,
b) earnings, and
a) unearned income.
• Some states supplement the federal amount for some or all living situations. |
• Either eligible for a full benefit checks or ineligible and
receive no benefits.
•
Amount based on:
a) earnings history of wage-earner,
b) age when benefits begin, and
c) number of people in addition to the wage-earner who are receiving benefits.
•
If benefit amount is less than SSI FBR ($674 in 2009), may also be eligible for
SSI. |
When
Checks Arrive |
First day of the month; if the 1st is a holiday or weekend, the check
arrives on the business day before the 1st |
• People who qualified for SSDI before May 1997:
arrives 3rd of the month
•
Qualified after May 1997 and birthday between:
a) 1st -10th: arrives 2nd Wednesday
b) 11th - 20th: arrives 3rd Wednesday
c) 21st - 31st: arrives 4th Wednesday |
| Funding
Source |
Annual Congressional
appropriation from the “General Fund” |
Social Security
Trust Fund, FICA taxes |
| Laws
and Regulations |
• Title XVI (16) of the Social Security Act (Title 42 US Code,
the Public Health and Welfare, Chapter 7, Subchapter XVI)
•
Regulations in 20 CFR; Part 416 |
• Title II (2) of the Social Security Act (Title 42 US Code,
The Public Health and Welfare, Chapter 7, Subchapter II)
•
Regulations in 20 CFR, Parts 400 - 499 |
| Medical
Benefits |
• Medicaid eligible in 32 states.
•
In other states must apply separately for Medicaid.
•
Eligible the month of SSI application and possibly three months retroactively |
Medicare eligible (Parts A and B), 24 months after person qualifies
for SSDI |
| Monthly
Cost (Premium) |
None |
SSDI recipients with yearly incomes less than $85,000 have $96.40 (2009) deducted from their check each month. If SSDI recipient also receives SSI, then Medicaid will pay the monthly Medicare premium. |
| Deductible |
None, but there may be “cost sharing” instituted
by states for various services. |
Yes–in 2009 the Part B deductible is $135/ year.
If person also receives SSI, Medicaid pays the deductible. |
| Co-pay |
Possibly none, however states may elect to have small
co-pays for medications, services, hospitalization. |
20% of costs deemed allowable by Medicare; 100% of
costs not deemed allowable by Medicare. If person also receives SSI,
then Medicaid pays all “co-pays.” |
| Range
of Coverage |
Very comprehensive. Generally covers doctor visits;
prescriptions; dentures; glasses; hospital, hospice care; home help services/personal
care and other costs. Pays Medicare premium for concurrent recipients.
Pays premiums for private insurance when cost effective. Coverage may
vary from state to state. |
Hospital costs primarily. Some home health care and
durable medical equipment. Usually does not cover prescriptions, glasses,
dentures, day-to-day medical costs, and doctor visits. However, due to recent
changes, Medicare will pay for comprehensive care at select
clinics, and since 2006 there is a Part D prescription benefit that pays substaintial costs for most people. |
| Proof
of Coverage |
Card comes monthly. Lists person(s) covered, their
recipient ID# for billing, Managed Care Provider, and contract number
of other insurance (such as Medicare) that should be billed first. |
Permanent wallet sized card–white with red and
blue stripe. Names person covered, coverage, and date coverage began. |
