Major Life Changes

With a progressive disability, you have to keep in mind that your disability will change over time. Most of this article is dedicated to figuring out how you can make adjustments that will allow your life to continue to be pretty similar to the way it is now. However, your disability may also mean that there will be major changes in your life.

Here we’ll talk about a few major changes that could happen:

• If you need to change jobs
• If you need to get a new type of health coverage
• If you need to start getting cash benefits

These possibilities are introduced briefly here. For more detailed information, we will refer to various DB101 articles about different benefits programs.

Changing Jobs

One of the changes that can occur as your disability progresses is that it reaches a point where you have to leave your current job and need to find a different one. For example, if you need to lift heavy objects at your job and your disability is impacting your ability to lift them, you may need to find another job which does not require physical strength.

If you have to leave your job and find a new one that you can do with your disability, there are some good resources that can help you. Here we’ll introduce a couple of them, Vocational Rehabilitation and Minnesota CareerForce.

What they offer

Vocational Rehabilitation Services (VRS) and CareerForce locations both can supply you with a wide variety of counseling, training, job skills, and job placement services.

With VRS or, if you are blind, State Services for the Blind (SSB), you will get a counselor who knows about disability issues and can help you find work that you can continue to do as your disability progresses.

CareerForce locations help people with and without disabilities reach their employment goals. They have assistive technology to help people with disabilities use their services and resources. You can also just stop by if you want to try out these technologies.

How you get services

Eligibility for VRS is based mostly on whether you have a physical or mental disability that makes it difficult to prepare for, get, or keep work. If you get Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI), you are automatically eligible for VRS through the Ticket to Work (TTW) program. If you’re in Ticket to Work, you can also choose to get similar services from other Employment Networks.

To get services through VRS or at a CareerForce location, just contact your local CareerForce location. Find a Minnesota CareerForce location near you, or call 1-651-259-7501.

When they’re a good option

VRS is a good option if you don’t have a job and want to get one or if you want to get additional training and education to get a job. It’s especially good if you are on SSI or SSDI benefits, because you will be guaranteed services without having to get on a waiting list.

CareerForce locations supply these services to all jobseekers, whether or not you have a disability. This means that if you don’t qualify for VRS or if VRS puts you on a waiting list, you can still get a lot of good services that can help you get a job.

Read more about Vocational Rehabilitation Services and CareerForce locations in DB101’s Programs That Support Work article.

Finding Health Coverage

With a disability, a top priority is to make sure you have health coverage. Your financial situation, employment status, and disability status impact what types of coverage you can get. If you have to lower the number of hours you work or have to leave your job as your disability progresses, you may have to find different health coverage. These are the main options:

• Private health coverage, including employer-sponsored coverage and MNsure, the Health Insurance Marketplace for the State of Minnesota

• Minnesota public health programs, including Medical Assistance (MA), Medical Assistance for Employed Persons with a Disability (MA-EPD), and MinnesotaCare

• Medicare

These programs will be introduced briefly here. For more detailed information about them, see DB101’s Health Care Coverage section.

Private Health Care Coverage

Private health care coverage is the most common type of health coverage.

What It Provides

It pays for some of your medical costs when you see a doctor, go to the hospital, get medical exams, or get prescription medicine. You may need to pay copayments, premiums, or deductibles for these services. Depending on your coverage plan, it may pay for almost the entire cost of your medical expenses, or it may pay only a portion of those expenses. If you have low income and get private coverage through MNsure the government may help pay your premium.

How You Get It

The most common way of getting private health coverage is through your job or your spouse’s job. Many, but not all, jobs offer health care benefits. If you are still working and get health coverage through your job, your employer will continue to pay most of the expenses for your health insurance. Your spouse or parent (if you’re under 26) may also have a job that will provide health insurance for you.

You can also buy your insurance directly from a private insurance company, through an insurance broker, or on MNsure. You can buy private coverage for yourself and for your entire family. Insurance companies cannot reject your application or charge you more because you have a health condition. MNsure is the only place where people who have lower incomes can get government help paying for their individual coverage plan.

When It’s a Good Option

Private health coverage is best when you or your spouse (or parent) has a job where the employer will pay for it. Or, depending on your income and your plan, the government may help pay for your premium. To get government help paying your premium, you must buy a plan through MNsure. Note: There is no income limit for getting subsidies that help pay individual coverage premiums. (Before 2021, the limit was 400% of FPG.) To get subsidies, you still must meet other eligibility rules and the premium amount you pay depends on your income and your plan.

It’s important to also note that private health coverage doesn’t always cover everything – you may get private coverage and also be able to get public health coverage to cover whatever the private insurance doesn’t pay for.

Read more in DB101’s Individual Coverage article.

Minnesota Health Care Programs

Minnesota has several different public health coverage programs that you may qualify for. Three of the most important for Minnesotans with disabilities are:

• Medical Assistance (MA)
• MinnesotaCare
• Medical Assistance for Employed Persons with Disabilities (MA-EPD)

What They Provide

MA, MinnesotaCare, and MA-EPD help pay medical expenses for people with disabilities, older adults, children, pregnant women, and people with low income.

If you qualify, these programs will help pay for your visits to the doctor, hospital stays, prescription drugs, medical equipment, and other medical services. You may need to pay copayments, premiums, or deductibles for these services.

There are a couple of differences between these programs:

1. They have different income and asset limits. Depending on your situation, it may be easier for you to qualify for one of these programs or the other.
2. You have to pay a monthly premium to get MinnesotaCare or MA-EPD, while MA has no premium.

How You Get Them

You can apply for Minnesota public health programs online at MNsure, or you can get help applying at your county or tribal human services office.

Note: The only way you can apply for MA-EPD is by filling out the Minnesota Health Care Programs Application for Certain Populations and taking it or mailing it to your local county or tribal human services office. You cannot sign up online.

When They’re a Good Option

If you or your spouse (or your parents, if you’re under 26) don’t have jobs where the employer will provide you with private health coverage, the public health care options listed here are your best bet. If you have very low income and assets, you may qualify for MA. If your income and assets are a bit higher, you may still qualify for MinnesotaCare. If you are working and have a disability, you will likely qualify for MA-EPD. They can also help if your private health coverage doesn’t cover some of your medical expenses.

Read more about MA, MA-EPD, and MinnesotaCare in DB101’s section on Health Care Coverage.

Medicare

Medicare is another public health program, but it is run by the federal government, not by the state. While you work, some of the money you earn automatically comes out of your paycheck and goes into a Medicare fund. If you become disabled and start getting Social Security Disability Insurance (SSDI), you will start getting Medicare 2 years after your SSDI benefit begins.

What It Provides

Medicare has different “parts” that each help pay for your medical care.

• Medicare Part A helps pay for medical care you get while you’re in a hospital.
• Medicare Part B helps pay for medical care you get outside of a hospital, like when you go to the doctor.
• Medicare Part C, also known as Medicare Advantage, is a way to get Part A, B, and sometimes Part D coverage through private companies.
• Medicare Part D helps pay for prescription drugs.

Each Medicare part has different rules for how you sign up, how much you have to pay in premiums or copayments, which medical costs it helps with, and how much of the costs it will help pay for.

How You Get It

People with disabilities get Medicare after being on Social Security Disability Insurance (SSDI) for 24 months. SSDI provides income for people have worked and earned enough work credits to qualify, but who can no longer work because of a disability. Once you’ve been getting SSDI for 2 years, you automatically qualify to get Medicare and will begin to get coverage without having to fill out an application.

In the two years before you qualify for Medicare, you’ll need to get coverage through one of the other health coverage options introduced in this article.

When It’s a Good Option

Medicare is always a good option if you qualify. Often it can also be combined with other programs, such as Medical Assistance (MA), so that your share of expenses is lower.

Read more about Medicare in DB101’s Medicare article.

Getting Cash Benefits

There are several important benefits programs that can supply you with income support when your disability limits your ability to work. Your work history, financial situation, and medical condition will impact which cash benefits you qualify for. These are the main options:

• Short-Term Disability Insurance and Long-Term Disability Insurance
• Social Security Disability Insurance (SSDI)
• Supplemental Security Income (SSI)
• Workers’ Compensation

These programs will be introduced briefly here. For more detailed information about them, see DB101’s section about Cash Benefits.

What they offer

• Short-Term and Long-Term Disability Insurance replace some of your income if an injury or illness prevents you from working. Unlike Workers’ Compensation, to get benefits through disability insurance, your injury or illness does not need to be work-related. The amount of money you get each month and the length of time that you get benefits depends on your insurance plan.
• While you work, some of the money you earn automatically comes out of your paycheck and goes into a Social Security fund. If you have to stop working because of your disability, Social Security will take money from this fund and pay you a monthly cash benefit called Social Security Disability Insurance (SSDI).
• If you have a disability, don’t have enough money for your basic needs, don’t have much income, and have limited assets, you may be able to get Supplemental Security Income (SSI), a monthly cash benefit. Many people who qualify for SSI also qualify for Medical Assistance (MA), Minnesota Supplemental Aid (MSA), and SNAP.
• Workers’ Compensation is a type of insurance that supplies you with benefits if you become injured or disabled while you’re at work. All employers are required to supply you with this insurance. Generally speaking, most progressive disabilities are not caused by work, but if you were injured at work, you may still be entitled to Workers’ Compensation for expenses related to that injury.

How you get them

• To get private disability insurance benefits, you must be covered by a Short-Term Disability Insurance or Long-Term Disability Insurance plan. Common ways you may be covered are through your job or through other groups you may be a member of, such as a trade union, alumni organization, or other professional organization.
• You can apply for Social Security Disability Insurance (SSDI) online, by calling Social Security at 1-800-772-1213 or 1-800-325-0778 (TTY), or by visiting your local Social Security office.
• You can apply for Supplemental Security Income (SSI) at your local Social Security office or by calling 1-800-772-1213 or 1-800-325-0778 (TTY). If you need help applying for SSI, contact a Social Security Advocate.
• If you become injured at work, you need to notify your supervisor or Human Resources department as soon as possible. You should do so in writing (a letter or email), so that there is a record that you reported your work-related injury or disability. Your employer will then report your injury to the Workers’ Compensation insurance company.

When they’re a good option

• Short-Term and Long-Term Disability Insurance are always good options, if you are covered. The biggest problem is that most people don’t know about it and so often are not covered. Read more about private disability insurance in DB101’s Short-Term and Long-Term Disability Insurance article.
• SSDI is a great benefit for anybody who qualifies. The benefits can begin when you have had a qualifying disability for 5 months. Also, you automatically become eligible for Medicare health coverage after getting SSDI for 2 years. To learn more about SSDI, read DB101’s SSDI article.
• SSI can be a huge help for you if you have low income and low assets. As with SSDI, to get this benefit, your disability must meet Social Security’s adult definition of disability. To learn more about SSI, read DB101’s article on SSI.
• Workers’ Compensation is important if you have an injury that happened at your work. If you have a disability that prevents you from working that was not caused by your work accident, you will not get Workers’ Compensation benefits. To read an excellent guide to Workers’ Compensation in Minnesota, click here (PDF).

Don't Confuse SSDI and SSI

The Social Security Administration (SSA) runs 2 different important programs for people with disabilities:

1. Social Security Disability Insurance (SSDI) pays cash benefits to people who have worked long enough and paid into its insurance system before they became disabled.
2. Supplemental Security Income (SSI) pays cash benefits to people with disabilities who have low incomes and low assets.

You may qualify for one or both of these programs.