criteria. Some programs, such as Social Security, base the benefit on the earnings of the worker prior to her disability or retirement. Some benefits are entitlements, such as Medicare, which is available to all people who have attained age 65. Other programs measure the current income and resources of the disabled person to establish eligibility. Supplemental Security Income and Medicaid are two such “means-based” programs. In order to access these benefits, the recipient must not only be aged, sick and/or unable to work, but also poor. If significant assets become available to the recipient, the benefits will be curtailed until those assets are used up. When the excess assets are gone, the recipient can reapply for the benefits.
Government benefits for persons who are disabled include cash payments and health care. Supplemental Security Income and Social Security Disability Income provide cash for these individuals. For many people, this is the only cash that they receive. They are too sick, too weak, or too old to access any other forms of cash. The major government health care programs are Medicare and Medicaid. Medicare provides coverage for acute care, such as hospitalization, and some rehabilitation, but it does not cover the cost of prescriptions or the cost of long term custodial care. Medicare recipients may also have access to private health insurance, which often pays for prescriptions and doctor visits. However, most health insurance policies will not cover long term custodial care. Long term care insurance will pay for custodial care, but it is not available for someone who is already disabled. Medicaid is the only government program in the United States that provides for long term skilled nursing care for persons with disabilities other than the Veterans Administration. Medicaid pays for prescriptions, therapy, and doctor visits as well as custodial care.
Families who are planning for a family member who is disabled know how critical these benefits are. In the past, families would either intentionally disinherit the loved one or attempt to create oral trusts or other arrangements with surviving family members. These methods often had heart breaking and cruel results or were ineffective or fraudulent. On the other hand, many families could not bring themselves to disinherit their loved one. As a result, the beneficiary who is disabled would receive a share of the estate outright, and lose his or her government benefits