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
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
elimination of lifetime dollar limits and annual dollar limits from
all health 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
issue and renewal of policies, and waiting periods for insurance
coverage of no more than 90 days.
detailed information, visit www.ncsl.org/portals/1/documents/health/hraca.pdf.
If I am Awarded Disability Benefits - Do I Still Need to Purchase
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
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