Understanding Government Benefits for Special Needs Planning


For the parent or guardian of someone with special needs, government benefits can be confusing. Between the acronyms, eligibility requirements and applications, caregivers often have misconceptions about their loved one’s eligibility or how to apply for benefits.

A large portion of special needs planning involves helping people with special needs receive the benefits to which they are entitled. Public benefits offer a wide range of assistance for living expenses and care options. These benefits work as a foundation for the care and support for individuals with special needs.

Below are a few public programs that provide care and support for families caring for a loved one with special needs.

Supplemental Security Income (SSI)

SSI provides monthly income that is paid to people with low income who are 65 or older, blind or disabled. To qualify for SSI, adults or children with special needs must meet the requirements below.

  • The individual must have a physical or mental condition, or a combination of both, that cause serious limitations.
  • The applicant’s condition(s) must have been disabling for at least 12 months, or is (are) expected to be continually disabling.

Once an application for benefits has been completed, the state agency will review it and determine the applicant’s eligibility. Depending on the severity of the applicant’s disability, SSI payments may be paid right away.

Social Security Disability Insurance (SSDI)

SSDI is an insurance program that provides regular payments to people who are unable to work because they have a medical condition that restricts their ability to be employed.

Eligible for SSDI is based on employment history and the number of Social Security Credits earned during the applicant’s time of employment. Unlike SSI, SSDI is not affected by an applicant’s income level or assets.


Medicare is a health insurance program for people older than 65 and those who are younger than 65 and have disabilities. The program covers a portion of the costs of health care and long-term care.

Medicare is broken down into the following four sections.

  1. Part A: Hospital insurance which helps pay for inpatient care in a hospital, nursing home and some home and hospice care.
  2. Part B: Medical insurance that pays for health services, outpatient care, home health care, medical equipment and some preventative services.
  3. Part C: Medical Advantage plans that cover many health care services from certain provider organizations.
  4. Part D: Prescription drug coverage that pays for the cost of prescription drugs.

Eligibility for Medicare is decided based on the applicant’s age, disability level and previous contributions to Medicare taxes.


Medicaid is an insurance program that covers health care costs for those with a low-income level. It covers children, elders, the blind and those with disabilities. Common benefits of Medicaid include health care, long-term care, medical equipment, in-home care and living assistance.

In many states, Medicaid is automatically included when a person is approved for SSI. Because Medicaid is controlled by individual states, eligibility requirements vary. A recipient must meet the following general qualifications:

  • Still are disabled.
  • Meet all other eligibility rules, including the resources test.
  • Need Medicaid in order to work.

These are but a few of the government-funded benefits available to those with special needs. Trying to understanding eligibility requirements and the application process can easily overwhelm and discourage families with a loved one with special needs.

To ensure your loved one is receiving the benefits to which he or she is entitled, be sure to thoroughly research eligibility requirements and consider contacting special needs planning expert Richard L. Newman, Attorney at Law for assistance.

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