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Understanding Medical Relevance of Social Security Disability Insurance
By By Karen Hercules-Doerr
August 1, 2011

Hospitals and healthcare providers often have familiarity, if not expert knowledge, about Medicaid and Medicare health insurance programs. This also can be true of the Supplemental Security Income (SSI) program, which is a means-based financial aid program administered by the Social Security Administration. Organizations are searching, if not scouring, for resources they can provide to help uninsured and underinsured patients cover the costs of their healthcare needs.

There is, however, a patient population at risk of becoming uninsured who could be helped at a future time through the Social Security Disability Insurance (SSDI) program. SSDI is a federal insurance program, mandated and funded by working taxpayers, that provides a monthly income to people who can no longer work because of a severe disability.

SSDI supplies a safety net for workers by providing regular monthly benefits based on their taxes and income during their working years. After a waiting period, those who qualify for SSDI are eligible for Medicare benefits no matter their age. These are important benefits from a program that may be overlooked by healthcare professionals who have a focus on meeting the immediate gaps for their uninsured populations.

Critical Considerations for Insured Disabled Workers

Patients who have health coverage at the outset of their condition, whether traumatic injury or chronic illness, may risk losing their medical insurance. Over time, their disability may become severe enough that they lose their jobs, and thus their employer-provided medical insurance. Even if a patient has personal medical insurance, the financial hardship resulting from a disability could make premium payments unaffordable. For a hospital, that means treating a patient with a chronic condition who eventually loses the ability to pay for health coverage.

People who eventually receive SSDI benefits and Medicare coverage can start out looking like anyone else in the working population, according to a 2009 study, “Health Insurance and Health Care Access Before And After SSDI Entry,” by The Commonwealth Fund. Individuals who eventually receive SSDI benefits are nearly as likely to be employed and have health coverage through their employment, although their household income may be below the federal poverty level. For example, about three years prior to entering the SSDI program, 40 percent received medical insurance from an employer and about 78 percent reported having medical insurance of some type.

Other factors about this group of workers are significantly different. More than 40 percent reported activity limitations, in comparison to 14 percent of all working-age people. In addition, average healthcare expenditures for working-age people with disabilities are about five times higher than for those counterparts without disabilities.

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