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Social Security Disability Tip of the Month 


On March 23, 2010 President Obama signed into law  The Patient Protection and Affordable Care Act (PPACA), commonly called Obamacare or the Affordable Care Act (ACA) .

Together with the Health Care and Education Reconciliation Act, it represents the most significant regulatory overhaul of the country's healthcare system  since the passage of Medicare and Medicaid in 1965.

The ACA aims to increase the quality and affordability of health insurance, lower the uninsured rate by expanding public and private insurance coverage, and reduce the costs of health care for individuals and the government.


For your convenience, Insler & Hermann, LLP has summarized some of the the ACA's key provisions and reforms of this landmark bill that will directly affect Social Security Disability beneficiaries.  


In October Insler & Hermann, LLP will publish an expanded newsletter to provide you with important information and useful links to help you better understand The ACA and find health insurance that fits your needs.  


Simple Overview of the Patient Protection & Affordable Care Act (ACA)

 How ACA Affects Social Security Beneficiaries   

The Patient Protection & Affordable Care Act (ACA) was passed into law  in March 2010 with the purpose of making healthcare more affordable and accessible.   

Paying for necessary medication or healthcare in general is often one of the biggest obstacles facing a disabled  individual.  Although Medicare now includes limited prescription drug coverage, Social Security Disability beneficiaries are not eligible for Medicare until 30 months after their first day of disability


The ACA makes preventative care - including family planning and related services - more accessible and affordable. The ACA requires that every individual have insurance, though there are some exceptions such as financial hardship or religious beliefs. Those who opt not to purchase health insurance will be required to pay a penalty. Therefore, in order to help individuals find and purchase affordable health insurance, the ACA requires the creation of state or multi-state based healthcare exchanges. This is commonly referred to as the Health Insurance Marketplace.


For people with disabilities, the most important reform is likely the prohibition against denying coverage based on pre-existing conditions. However, the ACA implements a number of other crucial reforms that will have a direct impact on the disabled. Some notable examples include:

  • The elimination of lifetime dollar limits and annual dollar limits from all health insurance plans;
  • Insurance plans may not rate premiums differently based on gender, health status, past claims experiences, or industry. Beginning in 2014,  health insurance premiums may only vary by age, tobacco use, geography and whether coverage is for an individual or family;
  • Guaranteed issue and renewal of policies, and waiting periods for insurance coverage of no more than 90 days.

For more detailed information, visit www.ncsl.org/portals/1/documents/health/hraca.pdf.  


What If I am Awarded Disability Benefits - Do I Still Need to Purchase Health Insurance?  

Disability beneficiaries are entitled to begin receiving Medicare 30 months after their first day of disability (or once they turn 65). Unless an individual is eligible for Medicaid, he/she must purchase coverage through a Health Insurance Marketplace during the interim in order to avoid paying a fee. The majority of people receiving supplemental security income are eligible to receive Medicaid. 


Insler & Hermann, LLP will publish an expanded newsletter in October providing important information and useful links to help you navigate the ACA and find the health insurance benefits that best fit your needs.


Visit www.nymetrodisability.com for more information about ACA and other important Social Security Disability Tips. 



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Insler & Hermann, LLP

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Winning Social Security Disability Cases since 1981

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Call our Social Security Disability Hotline (877) 773-3030