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  • Writer's picturelisaannettestanley

MediMed Resources for Special Needs Kids

Children with Disabilities

The attempted “Repeal & Replacement” of the Affordable Care Act is kind of important for millions of people, people like myself, who otherwise would go without coverage without Obamacare.

For that reason, I guess I will keep blogging until the final vote takes place. I am all about SOLUTIONS.

The really the important point to keep in mind: ObamaCare is the HealthCare coverage of last resort.

The majority of Americans get their coverage through Employee Benefits until age 65 or retirement when they become eligible for Medicare. Certain Low Income individuals get coverage through Medicaid.

Should the Republicans manage to pass a Health Plan that’s takes coverage away from citizens, there is a possible solution for the Disability Community: Medicare Under-age Disability: the Medi/Meds. (Duel Eligibles)

In reading the latest attempt to pass new legislation this year, it looks to me that those Medicaid recipients that would be most affected by de-funding or reduced funding of Medicaid would be those covered by the Medicaid EXPANSION.

There was nothing in the language of the Bill that would indicate cutting funds to Medically Needy Children. That having been said, what I read was not the full text of the Bill – so who knows if there’s hidden language in there?

The Medicaid recipients that are most at risk are those who gained new coverage under the Affordable Care Act that gave the States authority to expand coverage for people who were not previously eligible.

In general, Medicare Benefits are necessarily tied to Social Security in that the Medicare Part B Premium is paid by Social Security payroll taxes that we all pay.

Medicare Underage Disability IS available to children with disabilities whose parents have paid Social Security taxes &

  1. Have certain qualifying Medical conditions

  2. Have been receiving SSI/SSID for 12 months

  3. Certain critical conditions qualify immediately (See below)

If approved for BOTH types of coverage, these children would be the “Medi/Meds” I described here:

Medicare is Federal Coverage, Medicaid is State coverage.

If the worst-case scenario of possible Legislation does pass, BOTH types of coverage may be needed to protect the Health Care needs of our Special Needs Children.

Medicare itself was only ever intended to be an “80/20 Plan” with insured needing to cover 20% of their total Out of Pocket Medical Expenses. This would have the same effect of piecing together a Medicare Supplement to fill the gaps in coverage.

Medicaid is administered by the individual states, is tied to the National Poverty Level & has a mind-numbing number of possible Categories of Qualification Levels. (Star Plus, QMB, SLMB, QWDI, ect)

In my opinion, this would be the best course of action for any parent of a Special Needs Child.

  1. Keep your Medicaid in whatever re-incarnation is available should the Republican Bill pass

  2. Apply for SSID if you haven’t already https://www.ssa.gov/pubs/EN-05-10026.pdf

We can find a way to take care of our medically fragile citizens.

The people who will be most affected by a repeal of ObamaCare are the millions of people like myself who don’t fit any of these categories.


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