Public Benefits

hand holding a benefit security card

People with disabilities deserve access to the public benefits that they are entitled to by law. Access to public benefits such as health insurance programs and Social Security Disability promotes the dignity, independence, and accessibility of people with disabilities in Wisconsin. Navigating such programs—including Medicare and Medicaid—can be overwhelming and confusing. Without the expertise of a specialist, people with disabilities and their families may be missing out on programs or opportunities to which they are entitled.

Public benefits that individuals with disabilities may be eligible for:

Social Security Disability Insurance (SSDI)

Pays benefits to people with disabilities who have worked and paid Social Security taxes on their earnings, and to certain dependents of a worker who has retired, become disabled, or died. Eligibility, and amount of benefits, depends on how long the insured person worked, how much money s/he earned, and how many people are being paid from his/her account. There are no income or resource limits, but earnings from work may result in loss of disability-based benefits. Eligibility for SSDI based on disability will make a person eligible for Medicare after a waiting period of two years.

Supplemental Security Income (SSI)

Pays benefits to people with disabilities whose income and resources are below set limits. Sometimes, resources and income of parents and spouses are counted. The person or family does not have to have a work history. Eligibility for SSI will make a person eligible for Medicaid which can be retroactive for up to 90 days. A person eligible for SSI in Wisconsin may receive a State of Wisconsin SSI Supplement. This benefit is administered by the state under state laws and policies.

Medicaid and BadgerCare

Medicaid and BadgerCare are comprehensive health care insurance programs available to certain low-income persons with limited assets. Medicaid is also available to individuals whose income is reduced to the low-income level when medical expenses are deducted from their gross income. These programs pay service providers for medical and rehabilitative services, drugs and equipment which they have provided to a Medicaid or BadgerCare enrollee. Both programs are administered by the state and funded by federal and state dollars.

Do you have questions or need help with Medicaid? Our SSI Managed Care External Advocacy Project may be able to help you.

Medicare

Medicare is the national health insurance program for all Social Security recipients who are either over age 65 or permanently disabled. Individuals receiving Railroad Retirement benefits and people with end-stage renal disease are also eligible for Medicare coverage.

Medicare is not a “welfare” program. Eligibility is not based on financial need. Procedures should not vary significantly from state to state and coverage is similar to that provided by private insurance companies: it pays a portion of medical costs. Often, deductibles and coinsurance (partial payment of initial and subsequent costs) are required of the beneficiary (person receiving medical services).

Do you have questions or need help with Medicare Part D?  Our free Disability Drug Benefit Helpline may be able to help you.

Medicaid Waiver

Medicaid (Medical Assistance, MA) Waiver programs provide funding through county Departments of Human Services (also called Departments of Community Programs or Unified Services Boards) for community services to qualified persons with developmental disabilities, traumatic brain injuries, physical disabilities, or persons age 65 or over who meet the eligibility requirements for institutional care. The MA waivers are composed of an actual application to waive federal rules, and require approval from the Federal Health Care Financing Administration (HCFA). The funding is allocated for each eligible individual through the county agency.

How SSA Evaluates Disability

The definition of disability under Social Security is different from other programs. Social Security pays only for total disability. No benefits are payable for partial disability or for short-term disability. Please see the SSA Disability Planner for more qualification information.

Strategies

Disability Rights Wisconsin assists persons with disabilities with public benefits through many of our programs.

Self-Advocacy Resources

Our self-advocacy resources have helpful guidance and further information on issues related to this topic. Learn more below:

  • Fact Sheet: [English] Social Security Administration Issues Frequently Asked Questions

    This self-advocacy fact sheet provides information on the following Social Security Administration topics:

    • Contacting the Social Security Administration
    • Eligibility
    • Representative payee
    • Fraud, waste, and abuse concerning SSI and SSDI
    • Identity theft
    • Overpayments
    • Discrimination by the Social Security Administration Office
    • Further resources
  • Fact Sheet: [Spanish] Social Security Administration Issues Frequently Asked Questions

    Este hoja informativa presenta información sobre la Administración del Seguro Social:

    • Información sobre la Administración del Seguro Social
    • Elegibilidad
    • Representante del beneficiario (Rep. Payee)
    • Fraude, despilfarro y abusos relacionados con el SSI (Seguridad de Ingreso Suplementario) y el SSDI (Prestaciones del Seguro Social por Discapacidad)
    • Tome medidas si sospecha de robo de identidad
    • Sobrepagos
    • Discriminación por parte de la oficina de la SSA
    • Más recursos

Referrals

Other places that may be able to help you:

  • ADRC of Central Wisconsin

    We are the first place to go with your aging and disability questions. Anyone can contact us, regardless of their financial status, to receive accurate, unbiased information on all aspects of life related to aging or living with a disability.

  • Aging and Disability Resource Centers (ADRC)

    The Aging and Disability Resource Centers throughout Wisconsin provide a variety of services to people with disabilities and older adults including connecting to community resources, benefit specialist services, and long term care options counseling.

  • Consumer’s Guide to Legal Help

    findlegalhelp.org is provided as a public service by the American Bar Association’s Division for Legal Services. While the information on this site is about legal issues, it is not legal advice or legal representation.

  • Disability Benefit Specialist Program

    The Disability Benefit Specialist (DBS) program helps to answer questions and solve problems related to Social Security, Medicare, health insurance, and other public and private benefits for people between the ages of 18 and 59.

  • Economic Justice Institute

    Programs are dedicated to serving low-income and other under-represented clients in matters designed to enhance access to justice and economic security.

  • Free Legal Answers

    American Bar Association

  • SSA Disability Planner

    To qualify for Social Security disability benefits, you must first have worked in jobs covered by Social Security. Then you must have a medical condition that meets Social Security’s definition of disability. This page covers requirements for SSDI.

  • Wisconsin Judicare Inc.

    Serves low-income people in 33 northern counties of WI. Handles cases involving bankruptcy, social security and SSI, family law, health, housing, income maintenance, wills, and Indian law.

Learn More

You can find more information on this topic from these websites and publications:

  • ABLE National Resource Center

    The ABLE National Resource Center (ANRC) is a collaborative whose supporters share the goal of accelerating the design and availability of ABLE accounts for the benefit of individuals with disabilities and their families.

  • Disability Benefit Specialists Fact Sheet

    Disability Benefits Specialists (DBS) help people with disabilities ages 18-59 to understand and access Social Security, Medicaid, Medicare, health insurance and other public and private benefits.

  • Find a Disability Benefit Specialist

    Find a disability benefit specialist or elder benefit specialist in your area.

  • Improving Access to Public Benefits

    The American Recovery and Reinvestment Act (ARRA) increased the funding and capacity for benefits across the board. These measures are meant to provide for America’s struggling families, but far too many miss out on the help they need.

  • Legal Action of Wisconsin

    Legal Action of Wisconsin provides civil legal services for low-income Wisconsinites across much of the state.  They assist with housing and eviction, public benefits, consumer law, and a variety of other issues.

  • What is a disability benefit specialist?

    Disability benefit specialists (DBS) help answer questions and solve problems related to Social Security, Medicare, health insurance, and other public and private benefits for people with disabilities.

Act

Want to do more to help protect individuals with disabilities? Please visit our Take Action Page for some ideas and to sign up for news and other alerts from our website. Or Donate Now to help protect and advocate for the rights and futures of all Wisconsin citizens. We'd love to have you join us.

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