Public Benefits or Public/Private Disability Insurance

If you, a family member, or friend has a life-threatening or serious chronic illness, you may also be dealing with the process of obtaining public benefits as well as public or private disability insurance to meet your health care needs. The following resources may be of assistance to you in the process of obtaining these benefits.

General Preparation for Disability

• Wisconsin Council on Developmental Disabilities: One Step Ahead Resource Planning for People with Disabilities Who Rely on SSI and Medical Assistance: Resource for individuals with long-term disabilities to help plan for ways to maintain financial security and ownership of property without jeopardizing eligibility for SSI and Medicaid benefits. See updates to this publication for 2006.
• Be Prepared: The Complete Financial, Legal, and Practical Guide to Living with Cancer, HIV, and Other Life-Challenging Conditions: See Chapters 8-11. This book contains virtually all facets of legal, financial and practical information for individuals facing disability, including surprising ways to pay bills with existing assets, employment issues and health insurance coverage. Thorough information on issues such as estate planning, the Americans with Disabilities Act, Social Security, Medicare, Medicaid New Investment strategies, and others are given. (Please note that the latest edition of the book was published in 2000, so some information provided may be outdated).

Applying for Public Disability Benefits through the Social Security Administration (SSA)

• B.E.S.T. (SSA Benefit Eligibility Screening Tool): Tool that can determine eligibility for any of the programs administered by SSA. (Please note that it cannot give estimated benefit amounts
• SSA Adult Disability Starter Kit: Includes information on definitions of disability, FAQs about applying for disability benefits, and a worksheet to prepare for the application.
• Supplemental Security Income (SSI): Provides description and links for SSI benefits, eligibility requirements, and procedures for application.
• SSA Publication "What You Need to Know When You Get Supplemental Security Income": Thorough description of SSI once determined eligible.
• Social Security Disability Income (SSDI): Provides description and links for SSDI benefits, eligibility requirements, and procedures for application.
• SSA Publication "What You Need to Know When You Get Social Security Disability Benefits": Thorough description of SSDI once determined eligible.

Understanding the SSA Appeal Process

• "Your Right To Question The Decision Made On Your Claim": Description of the appeal process if one's application for SSI or SSDI has been denied.
• SSA Reconsideration Request Form: Instructions and link to the Reconsideration Request Form.

Basic Information About Public Health Benefits

• Be Prepared: The Complete Financial, Legal, and Practical Guide to Living with Cancer, HIV, and Other Life-Challenging Conditions: See Chapter 15. Please see description of book above under "General Preparation for Disability." (Please note that the latest edition of the book was published in 2000, so some information provided may be outdated).
• The Medicaid Program: A Brief Overview: Summary of Medicaid and its general provisions from the AARP website. For Wisconsin's Medicaid program, please see "Public Benefits Available in Wisconsin" below. If you live outside Wisconsin, you may locate your state's Medicaid program information via the website for the Center for Medicare and Medicaid Services (CMS)
• Applying for Medicaid: Provides brief overview of applying for Medicaid as well as links to the website for the Centers for Medicare and Medicaid Services (CMS).
• Medicare: Provides overview of Medicare, the federal health insurance program for individuals age 65 or older and individuals with disabilities who have been entitled to SSDI for two years and five months.

Eligibility for Public Health Benefits

For Individuals in Wisconsin

• ACCESS: Tool for individuals in Wisconsin to determine their eligibility for health care programs such as Medicaid, Medicare Part D and Badger Care (BadgerCare Plus beginning February 1, 2008), in addition to nutrition programs such as FoodShare, WIC and The Emergency Food Assistance Program.

For Individuals in Any State

• National Council on the Aging Benefits CheckUp: Questionnaire targeted to individuals age 55 and older to find state and federal programs that can help them pay for prescription drugs, health care, as well as other needs.
• GovBenefits.gov Questionnaire: Questionnaire to help all individuals determine their eligibility for various state and federal benefits programs.

Public Benefits Available in Wisconsin

• Wisconsin Medicaid : This brochure explains Wisconsin Medicaid, a state/federal assistance program that helps certain low-income people individuals pay their medical bills. Wisconsin Medicaid is also known as Medical Assistance, MA, Title XIX, and T19. This brochure also provides information about Medicaid subprograms, including BadgerCare and Healthy Start. Note that individuals who receive SSI automatically get Wisconsin Medicaid.
• Medicaid Purchase Plan (MAPP) Program: The Wisconsin MAPP program offers individuals with disabilities who are working or interested in working the opportunity to buy health care coverage.
• BadgerCare Plus: Description and enrollment information for new BadgerCare Plus program in Wisconsin, which is accepting applications beginning February 1, 2008.
• Services for People with Disabilities: Provides links to public benefits available to individuals with disabilities in Wisconsin through the Department of Health and Family Services.
• Health Insurance Risk-Sharing Plan (HIRSP): The state of Wisconsin offers this high-risk health insurance plan to Wisconsin residents who either are unable to find adequate health insurance coverage in the private market due to their medical conditions or who have lost their employer-sponsored group health insurance. If you live outside Wisconsin, your state may offer a similar high-risk insurance plan. You may refer to the website for The National Association of State Comprehensive Health Insurance Plans (NASCHIP) (http://www.naschip.org/) for this information.

Benefit Specialists in Wisconsin

• State of Wisconsin Elderly Benefit Specialist Program: Benefit specialist program available to individuals age 60 and older throughout all counties in Wisconsin to provide information, assistance, and counseling concerning government benefit and entitlement programs. Assistance includes information about eligibility, help in applying, and appealing denials and terminations.
• State of Wisconsin Disability Benefit Specialist Program: Benefit specialist program available to individuals between the ages of 18-59 in 22 counties in Wisconsin to provide information, assistance and counseling to individuals with disabilities concerning government benefit and entitlement programs. Assistance includes information about eligibility, help in applying, and appealing denials and terminations.
• Work Incentives Benefits Specialists (WIBS): Provide assistance to people with disabilities by helping them wade through the complexities to make informed choices about the impact of work on their benefits. WIBS can provide a writen and oral analysis of a person's services and benefits and how work will affect their cash payments, medical coverage and continued eligibility. Two types of WIBS in Wisconsin include Fee for Service or Purchase of Service Benefits Counselors and the Work Incentives Planning and Assistance Program Counselors.

Private Disability Insurance

• Be Prepared: The Complete Financial, Legal, and Practical Guide to Living with Cancer, HIV, and Other Life-Challenging Conditions: See Chapter 8. Please see description of book above under "General Preparation for Disability." (Please note that the latest edition of the book was published in 2000, so some information provided may be outdated).
• The Motley Fool Insurance Center-Disability Insurance: Provides overview of private disability insurance, explanation of difference between long-term and short-term disability insurance, and factors to consider before purchasing private disability insurance either individually or through an employer.

Organizations for Individuals with Disabilities in Wisconsin

• Disability Rights Wisconsin: A statewide resource for individuals, families, service professionals and others concerned with disability issues. Serves as part of a national system of federally mandated independent disability agencies. Disability Rights Wisconsin offers a free guide, Rights & Reality II: An Action Guide to the Rights of People with Disabilities in Wisconsin, explaining the basic leagal rights and protections afforded to people living with disabilities in Wisconsin, including topics such as public benefits, voting rights, housing, service animals, commitments and others.
• IndependenceFirst: Provides more than twenty services for people with disabilities of all ages, and of all disability types in the Metro Milwaukee area. Offers printed materials in Hmong, Russian and Spanish as well as direct services in these native languages through bilingual staff and interpreters.
• Wisconsin Council on Developmental Disabilities (WCDD): The Council was created under federal and state law to engage in advocacy, capacity building and systems change activities to help individuals with developmental disabilities to be independent, productive and included in all facets of community life. The Council also provides a number of publications useful to families and individuals with disabilities.