Ask Larry

What Options Does My Son Have?

My son was diagnosed with schizoaffective disorder - bipolar type last year. He is being treated and has a monthly injection that costs $1600, plus the monthly doctor visit of $90. He is 25 and is currently on my health insurance through my work. We've been able to get a coupon through the manufacturer of the medication and they've have been able to negotiate the cost of the medication to $10 a month. He will be turning 26 in January and will not be able to be on my insurance. I'm trying to find the best options for my son to continue to receive the treatments. I'm thinking about applying for disability benefits for my son but I don't have the first clue on how to do this. Would I be applying for SSDI or SSI? Should I just apply for Medicaid or should it be Medicare? Can you please help?

Hi,

To potentially qualify for Social Security disability benefits (SSDI), a person must have the required amount of Social Security quarters of coverage (QC). The minimum number of quarters needed is 6, so your son would need to have worked and paid into Social Security for at least the equivalent of a year and a half to possibly qualify (https://secure.ssa.gov/apps10/poms.nsf/lnx/0300301140). If your son does qualify for SSDI, he would qualify for Medicare effective with the 25th month of his entitlement to SSDI.

SSI (Supplemental Security Income) and Medicaid are both needs based benefits, and a person can qualify for Medicaid without qualifying for SSI. There is no past work required for potential SSI eligibility, but you must have very little income and resources to qualify. There is a screening tool on Social Security's website: https://www.ssa.gov/ssi/.

I have no expertise in the Medicaid program, which is not connected with Social Security. To apply for Medicaid, I believe you would need to contact the Dept. of Social Services in your area. If your son doesn't qualify for Medicaid, have you considered the health care marketplace (https://www.healthcare.gov/)?

Best, Jerry

Posted: 
Nov 17 2017 - 6:47am
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