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| Government Assistance For Multiple Sclerosis |
Regardless of actual costs, a family would need to be quite wealthy to rely exclusively on family dollars to finance the long term expenses of the worst-case scenario. For this reason, it is absolutely essential for most families to create an estate plan that will ensure eligibility for government benefits. On the other hand, because government benefits are notoriously unreliable, a family should also make every effort to create an estate plan that relies on private dollars (including insurance dollars).
Government benefits may only be awarded after a lengthy or costly legal battle; they are subject to legislative change (and so are difficult to plan for); and rules for eligibility may be narrowed or changed administratively as government policies or resources change. For example, a little-known provision of the Health Insurance Portability and Accountability Act of 1996 has made it a criminal offense (punishable by fines of up to $10,000 and jail sentences of up to 1 year) to apply for Medicaid during the disqualification period that follows any transfer of assets from one individual to another (for the purpose of achieving Medicaid eligibility).
Thus, no application can be filed for Medicaid during the 36-month waiting period (60 months if a trust is involved) following the transfer of assets. This unfortunate provision, if allowed to remain, could seriously affect all elderly or seriously disabled individuals who look to Medicaid to cover the cost of nursing home services.
Government Benefits
WITH THOSE LIMITATIONS in mind, many people who have disabilities are eligible for benefits under one or more of several government programs. The design of the programs is generally to protect persons with disabilities by making sure that they have sufficient resources to provide the basic necessities of life, including food, clothing, shelter, and healthcare. The programs can be grouped into two categories: those based on financial need (i.e., Supplemental Security Income [SSI] and Medicaid), and those classified as social insurance programs (i.e., Social Security [SSDI] and Medicare).
The former are available to individuals with disabilities who satisfy certain financial restrictions. The latter are potentially available regardless of financial assets, and are based on the premiums that have been paid into the program during the person's years of employment.
Unfortunately, the rules relating to these programs are very complicated and constantly in flux. Generally, however, in order to qualify for benefits as a person with a disability, a person must be considered to have a "disability" within the meaning of the particular government program. Under the rules of the Social Security Administration (SSA), which are used by most government agencies, a person is considered to have a disability if he or she is unable to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment that can be expected to result in death or that can be expected to last for a continuous period of at least 12 months.
To SSA, a job constitutes "substantial gainful activity" if the pay is $500 or more per month, after deducting the cost of impairment-related work expenses. The rules are less strict for people who have visual impairments. To find out more, you can check out Government Assistance For Multiple Sclerosis.