Disability Benefit Specialist Program
Frequently Asked Questions about Public Benefits
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"Answers in American Sign Language" feature
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1)
What are SSA, SSI and SSDI?
See
the answer in American Sign Language
SSA
is the acronym for
the Social Security Administration. The Social
Security Administration is the federal agency that administers Social Security programs. There are
29 local Social Security offices in
Wisconsin.
ü
SSA administers the Supplemental Security Income (SSI) and
Social Security Disability Insurance (SSDI) programs.
ü
To find the office nearest you, you can call the SSA toll
free number at (800) 772-1213 Voice or 1-800-325-0778
TTY or visit the
SSA website and enter your zip code to find the office serving your
area.
SSI
stands for Supplemental Security Income, a program administered by the
Social Security Administration.
This program pays cash benefits to low income elderly, blind, or adults
with disabilities and children with disabilities.
ü
SSI is a “needs based” program, which means that you
must have very limited income and assets to qualify.
ü
People who receive the SSI benefit in Wisconsin
also receive Medicaid.
ü People
who receive the SSI benefit in Wisconsin receive a state SSI payment in
addition to their federal SSI payment.
ü
To apply for SSI, you can start the application
online or contact your local Social
Security office. Application assistance is available from the following
resources:
SSDI stands for
“Social Security Disability Insurance.” The SSDI program is financed
by payroll (FICA) taxes paid by employees, employers and by people who are self-employed.
ü
To qualify for SSDI benefits, you must be an
"insured" worker, which means that you have done some paid
work for approximately five out of the last 10 years and for half
of the years between age 21 and when you became disabled. Some special
rules apply for people under age 31.
ü
People who receive SSDI cash benefits receive a check from
SSA every month. The amount of your check depends on how much money you
have earned in the past.
ü
People who receive SSDI cash benefits receive Medicare
health insurance 24 months after they start receiving the cash benefit.
ü
The SSDI program provides “auxiliary” and
“survivor” benefits for certain dependent children under the age of
18 and their caregivers, disabled adult children and widow/ers and
divorced spouses of
insured workers who have become disabled, retired or died. Contact your
local SSA office to determine if you are eligible under another person's
wage record.
ü
To apply for SSDI, you can apply online
or contact your local Social
Security office. Application assistance is available from the following
resources:
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2)
Do Social Security and Medicare have Toll-Fee Numbers?
See
the answer in American Sign Language
The toll-free number for Social
Security is 1-800-772-1213 Voice or 1-800-325-0778 TTY.
ü Use
the toll-free number to:
-
Start
direct deposit
-
Replace a
lost or stolen Social Security card
-
Change your
address
-
Ask about
an overdue check
-
Get a
Society Security statement
-
Verify
benefits
-
Ask about
Medicare
ü
Use the local Social
Security
office phone number, not the toll free
number, to:
The
toll-free number for Medicare is
1-800-633-4227 Voice or 1-877-486-2048 TTY.
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3)
Can I apply for Social Security benefits online through the internet?
See
the answer in American Sign Language
Yes, you can apply for Social Security administered benefits such as SSI and
SSDI online at www.ssa.gov.
ü
The application for benefits is lengthy. If you choose to
apply for SSI or SSDI online, review the
Starter Kit documents to get an idea of what documents, papers,
dates and other materials you will need to complete the application.
ü
When you have prepared and are ready to begin the online
application, allow yourself at least four hours. Be sure to have the
documentation you may need with you at the computer.
ü
When you apply online, you will be given a Re-entry Number
that allows you to save your
application and finish it at another time. Be sure to write
this number down. If you lose this number, you will have to start
the application over. When
you are finished with the application, you can print it and/or save it
for your records.
ü
When the local SSA office receives your online
application, they will contact you. If you do not hear from the local
SSA office within five to seven business days after
submitting your online application, call and ask for an appointment.
ü
There are many things you can do online
with Social Security. They include:
-
Applying
for benefits (SSI and/or SSDI)
-
Use the
benefit planner and calculator
-
Request a
Medicare replacement card
-
Apply for
extra help paying for drugs under Medicare Part D
-
Sign up
for, or change, your direct deposit
-
Change your
address and phone number
-
Sign up for
email updates
ü
Application assistance is available from the following
resources:
4)
What is the difference between “Medicaid” and “Medicare?”
See
the answer in American Sign Language
Medicaid is a “needs-based” program, which means that it
is only available to certain low income individuals, low income elders and people with
disabilities.
ü
If you receive SSI benefits in Wisconsin, you automatically receive
Medicaid.
ü
If you have too much money to qualify for SSI, but you are
still low income, you may qualify for another type of Medicaid. If you
have not already been found disabled by the SSA, you will need to be
evaluated for Medicaid disability.
ü
All Medicaid applications are taken at your county Income
Maintenance Office or online through the Access.wisconsin.gov
tool.
ü
If you need an interpreter, contact the office before your
appointment. When possible, it is best to give advance notice of two
weeks when requesting an interpreter.
Medicare
is the health insurance program for people age 65 and older, and for disabled workers receiving
SSDI.
ü
Medicare begins after a person has received SSDI benefits
for 24 months. People with End Stage Renal Disease or Lou Gehrig's Disease (ALS) can receive
Medicare immediately.
Some
people are eligible for both Medicaid and Medicare.
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5)
What is the difference between Medicare Parts A, B, C and D?
See
the answer in American Sign Language
ü
When you receive Medicare, you are referred to as a beneficiary.
ü
Part A (see
the answer in American Sign Language) is
hospital insurance. This part of Medicare is called an entitlement,
which means you cannot lose this benefit unless you specifically decline
it. For most beneficiaries there are no premiums for Part A. There are
some co-payments and deductibles.
ü
Part B is
outpatient medical insurance that pays for things like doctor visits,
medical equipment and supplies. Part B requires that beneficiaries pay a
premium amount. The premium is deducted directly from your SSDI or
Social Security Retirement income benefit before you receive your check.
In 2008, the premium for Part B is $96.40 per month.
ü
For people who also qualify for Medicaid, Medicaid
pays the Part B premium, deductibles and co-payments. For some people who are slightly above the Medicaid
financial limits, the Part B premium can
be paid for by a different program called a Medicare Buy-in program.
The
Medicare Buy-in programs are called the Qualified Medicare Beneficiary
(QMB) and Specific Low-income Medicare Beneficiary (SLMB or SMLB+). You can apply for these programs at
your county Income
Maintenance Office or online.
ü
For people who also qualify for Medicaid, your primary
health insurance payer will be Medicare, and Medicaid will be the
secondary payer (meaning that Medicaid will generally pay for what
Medicare does not).
ü
Part C (see
the answer in American Sign Language) is the
name for the Medicare Advantage program. Medicare Advantage plans allow a
beneficiary to replace original Medicare Parts A and B with a plan
operated by a private insurance company. Medicare Advantage plans must
cover the same services as original Medicare Parts A and B, but can have
different cost-sharing and other rules.
ü
Beneficiaries interested in Medicare Advantage plans may
want to speak with an expert at the at 1-800-242-1060 Voice to weigh the pros and cons of the
various plans.
ü
Part D (see
the answer in American Sign Language) is the
prescription drug program for Medicare beneficiaries. Coverage is
offered through private, stand-alone prescription drug plans, or as part
of a Medicare Advantage plan. The Part D program is very complex.
ü
If you are younger than 60, you can contact the Disability
Drug Benefit Helpline at 1-800-926-4862 Voice or 1-888-758-6049 TTY.
ü
If you are age 60 or older, you can contact the Wisconsin
Prescription Drug Helpline at 1-866-456-8211 Voice, or an Elderly
Benefit Specialist to choose a plan that best suits your needs.
ü
When you are first eligible for Medicare, you can
decide to enroll or not enroll for Parts B and D. If you choose to not
enroll, you may have to pay late enrollment penalties if you choose to
enroll later on.
ü
Assistance with Medicare is available from the following
resources:
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6)
Do I get Medicare when I get Social Security Benefits?
See
the answer in American Sign Language
ü
Yes, you will be on Medicare after you receive SSDI
benefits for 24 months. If you have End Stage Renal Disease or Lou
Gehrig's Disease (ALS), you can receive Medicare right away.
ü
See the answer to question #1 above for a description of SSDI.
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7)
Where do I apply for Medicare?
See
the answer in American Sign Language
There
are two ways to receive Medicare:
ü
Receive SSDI
benefits for 24 months. An application for SSDI doubles as an
application for Medicare. Individuals will receive information from
Medicare in the mail three months before receiving Medicare.
ü Reach
age 65. Individuals who reach age 65 will receive information
from Medicare in the mail three months before their birthday.
ü
If you choose to enroll in Medicare Part C (also known as
a Medicare Advantage plan), you will need
to apply through the private insurance company.
Contact the Medigap
Helpline for more information before enrolling in a Medicare
Advantage plan at 1-800-242-1060 Voice.
ü
Applications for the Medicare Part D prescription drug program can be done online at www.medicare.gov,
by calling the Medicare toll free number at 1-800-633-4227 Voice, or by
calling the Part D plan in which you wish you enroll. Medicare Part D is a very complex
program.
ü
Anywhere in the state, you can contact the Disability
Drug Benefit Helpline at 1-800-926-4862 Voice or 1-888-701-1255
TTY. If you are age 60 or older, you can contact the Wisconsin
Prescription Drug Helpline at 1-866-456-8211 Voice or 1-888-758-6047
TTY.
Both of these resources can provide information about the Part D low
income subsidy, and help to figure out if people are eligible for extra
help to pay for drugs.
ü
Assistance with Medicare is available from the following
resources:
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8)
How do I apply for Medicaid?
See
the answer in American Sign Language
There
are two ways to apply for Medicaid:
ü
Contact your county
Income Maintenance office or your Aging
and Disability Resource Center. They can assist you to apply for
Medicaid.
ü
Access.wisconsin.gov
is an online tool you can use to help you apply for Medicaid online; to check your existing state benefits; or to determine if you are
likely eligible for a range of state-administered benefits,
including Medicaid.
Regardless
of how you begin your Medicaid application, you will need to meet with
an income maintenance worker at your county to verify income and to
satisfy other program requirements.
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9)
What are Benefit Specialists and what do they offer?
See
the answer in American Sign Language
There are three kinds of benefit specialists in
Wisconsin: Disability Benefit Specialists (DBS), Elderly Benefit
Specialists (EBS) and Work Incentives Benefit Specialists (WIBS). Benefit specialists provide information about a wide range of public
and private benefits programs.
ü
Disability
Benefit Specialists are part of the Aging and Disability
Resource Center (ADRC). They work with people who are ages 18-to-59 who
live in the ADRC
service area.
Some
of the programs that the Disability Benefit Specialist can help you
with are Medicaid, Medicare, Social Security Disability Insurance (SSDI),
Supplemental Security Income (SSI),
and FoodShare. The Disability Benefit Specialist can help you to
understand, apply for, and appeal decisions for these, and other
programs.
ü
Jason
Altmann is a disability benefit specialist working statewide
to serve people who use sign language as their primary means of
communication. Jason is part of the Office for the Deaf and Hard
of Hearing.
ü
People who are deaf may work with the Disability
Benefit Specialist if they are living in a county with an Aging
and Disability Resource Center, or with Jason.
ü
Jason is the only Disability Benefit Specialist
serving
the State of
Wisconsin. He can be contacted
at:
(888) 701-1246 TTY
(888) 330-5482 Voice
(262) 347-3045 Video Phone
Jason.Altmann@wisconsin.gov
ü
Elderly
Benefit Specialists are located in every county and work with
people ages 60 and older.
Some of the
programs the Elderly Benefit Specialist can help you with are
Medicare, Medicare Part D, Medicaid, Spousal Impoverishment Protection, Social
Security and FoodShare.
ü
Work
Incentives Benefit Specialists (exit DHS)
are available statewide, and work with people of all ages who
are receiving benefits and would like to work. They help people
understand the impact on their benefits from working and earning income.
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10)
Can I still receive SSI or SSDI if I am working?
See
the answer in American Sign Language
ü
Yes, you can continue to receive SSI and/or SSDI benefits
while you are working. The way work will impact your benefits depends on
the type of benefits you receive and the amount of work you do. It is a
good idea to check in with a Work
Incentives Benefit Specialist to be sure you understand how working
will impact your benefits.
ü
If you work while receiving your benefits, you will need
to report your income to SSA. To find the office nearest you, you can
call the SSA toll free number at 1-800-772-1213 Voice or at 1-800-325-0778
TTY or visit the SSA
website and enter your zip code to find the office serving your
area.
When you report your
earnings from employment, be sure to ask the SSA worker at the local
office for a receipt that documents your contact with SSA. Save this
receipt. It
is very important to save all notices, receipts and other papers that
you receive from SSA, the county or any other agency that you work
with.
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11)
What should I do if I receive an overpayment notice from SSA?
See
the answer in American Sign Language
ü
You may receive a letter from SSA saying that your
benefits have been overpaid based on the information SSA has about your
income, assets, living arrangement, and/or your family situation.
ü To
avoid a notice of overpayment, you need to report changes to your
household incomes and assets in a timely manner. When you report your
earnings from employment, be sure to ask the Social Security worker at the local
office for a receipt that documents your contact with Social Security. Save this
receipt.
ü It
is very important to save all notices, receipts and other papers that
you receive from SSA, the county or any other agency that you work
with.
ü
If you feel the
overpayment notice is incorrect, (see
the answer in American Sign Language)
you have a right to appeal this
decision.
ü
This is called a Requesting for Reconsideration of the
overpayment, and must be filed within 60 days of receiving the
overpayment notice.
ü
If you request reconsideration within 10 days of receiving
the overpayment notice, you may be eligible to continue receiving your full monthly
benefit until you receive a decision on your appeal. However, if the
overpayment is found to be correct, you will need to repay benefits
received while the appeal was pending.
ü
If you feel the
overpayment is correct (see
the answer in American Sign Language)
but you can’t afford to repay the
overpayment, you will need to request a waiver of the overpayment. You
will need to prove that the overpayment was not your fault, and that you
are financially unable to repay the overpayment. You will be asked to
provide detailed information about your monthly income and expenses.
ü If
you are still receiving SSI, Social Security will determine that you are
unable to replay the overpayment.
ü
A request for waivers can be filed at any time, but if you
have previously been found to be “at fault” in causing the
overpayment, a new decision will not be made.
12)
Do I
need to tell SSA if I move?
See
the answer in American Sign Language
ü
Yes. You must report your new address to your local Social
Security office. To find the office nearest you, you can call the SSA
toll free number at 1-800-772-1213 V or
1-800-325-0778 TTY or visit the SSA
website and enter your zip code to find the office serving your
area.
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Any questions about the Disability Benefit Specialist
program can be directed to the Office
for Resource Center Development.
Last Revised: September 04, 2009 |
