Social Security & SSI | Ticket to Work | Medicaid | Medicaid Waiver | Vocational Rehabilitation (VR) | Independent Living Services | County Services | Financial Planning
Social Security and Supplemental Security Income (SSI)
The Social Security and Supplemental Security Income disability programs are the largest of several Federal programs that provide assistance to people with disabilities. While these two programs are different in many ways, both are administered by the Social Security Administration and only individuals who have a disability and meet medical criteria may qualify for benefits under either program. When you apply for either program, medical and other information will be collected from you and a decision will be made about whether or not you meet Social Security's definition of disability.
Supplemental Security Income pays benefits based on financial need. Supplemental Security Income (SSI) is a Federal income supplement program funded by general tax revenues (not Social Security taxes). It is designed to help individuals with disabilities that have little or no income and provides cash to meet basic needs for food, clothing and shelter.
Social Security Disability Insurance
Social Security Disability Insurance pays benefits to you and certain members of your family if you are "insured," meaning that you worked long enough and paid Social Security taxes. For an online application go to the Social Security website.
Publications about how to apply for these programs are available on the Social Security website:
What You Need to Know When You Get Supplemental Security Income
Social Security website
Social Security Disability Planner
Ticket to Work
The Ticket to Work and Work Incentive Act of 1999 established an employment program for people who want to go to work that receive Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) benefits. The program was designed to remove barriers that kept people with disabilities from choosing to work for fear of losing health care coverage. The Ticket to Work program is voluntary, and it increases opportunities and choices for Social Security (SS) disability beneficiaries to obtain employment, vocational rehabilitation, and other support services from public and private providers, employers, or other organizations. SS provides a ticket to disability beneficiaries to use in obtaining services and jobs through the Missouri Division of Vocational Rehabilitation or from an approved Employment Network.
For more information, click on either of the following links:
The Medicaid Program, authorized by federal legislation in 1965, provides health care access to low-income persons who have a disability. Medicaid is a jointly funded, federal-state health insurance program. It covers children, the aged, blind, and/or disabled and other people who are eligible to receive federally assisted income maintenance payments.
Thirty-two states and the District of Columbia provide Medicaid eligibility to people eligible for SSI benefits. In these States, the SSI application is also the Medicaid application. Medicaid eligibility starts the same months as SSI eligibility. The following jurisdictions use the same rules to decide eligibility for Medicaid as Social Security uses for SSI, but require the filing of a separate application: Alaska, Idaho, Kansas, Nebraska, Nevada, Oregon, Utah, Northern Mariana Islands. The following states use their own eligibility rules for Medicaid, which are different from Social Security's SSI rules. In these states a separate application for Medicaid must be filed: Connecticut, Hawaii, Illinois, Indiana, Minnesota, Missouri, New Hampshire, North Dakota, Ohio, Oklahoma, Virginia.
In Missouri, The MO HealthNet program provides medical care for persons who are aged, or permanently and totally disabled, or who are blind. There is no cash benefit. MO HealthNet pays only providers of services and does not make direct payments to person for their medical expenses.The purpose of the MO HealthNet program is to provide medical services to persons who meet certain eligibility requirements as determined by Department of Social Services, Family Support Division. The goals of the MO HealthNet program are to promote good health, to prevent illness and premature death, to correct or limit disability, to treat illness, and to provide rehabilitation to persons with disabilities. Eligible persons receive a "MO HealthNet Identification Card" or a letter from the local FSD office. For more information about Medicaid eligibility,visit Missouri Department of Social Services MO HealthNet Division.
Download an application here.
What happens to Medicaid coverage if a SSI recipient works?
If a recipient`s state provides Medicaid to people on SSI, the recipient will continue to be eligible for Medicaid. Please refer to the general Work Incentives section for more information about SSI work incentives. Medicaid coverage can continue even it a recipient`s earnings along with other income become too high for a SSI cash payment.
Individuals with disabilities may be eligible for residential services support through Medicaid Waiver. Congress enacted Section 2176 of Public Law 97-35 of the Social Security Act, entitled the Omnibus Budget Reconciliation Act. Through this enactment in 1981, certain statutory limitations have been waived in order to give states, who have received approval from the Department of Health and Human Services, the opportunity for innovation in providing home and community based services to eligible persons who would otherwise require institutionalization in a nursing facility, hospital or intermediate care facility for the mentally retarded (ICF/MR). For more information about Medicaid Waiver visit the Missouri Department of Mental Health website.
Vocational Rehabilitation (VR)
Vocational Rehabilitation (VR) and Special Education share responsibility in preparing youth with disabilities for the transition from school to post-high school employment, education, specialized training and independence. The local school district is primarily responsible for providing transition-related services while a student is still in school. However for students with disabilities who are, or may be, eligible to receive vocational rehabilitation services, communication and collaboration with VR may help to ensure a smoother transition. VR's role is primarily one of planning and preparing for when a student graduates or exits the school system. Successful transition planning involves VR counselors and educators working together to encourage students and their families to think about goals for life after high school and develop a plan to get there.
Eligible students may receive one or more of the following transition-related services, which include but are not limited to:
- vocational planning
- career guidance and counseling
- on-the-job training
- assistance with finding a job
- independent living services at centers for independent living
VR also works in partnership with individual school districts to provide students with disabilities an opportunity to obtain high school credit for paid work experience prior to graduation or exit from school. This transition service is called the Cooperative Work-Experience Program (COOP), and it is provided through a formal interagency agreement between the local school district and the local VR district office. To learn more about the COOP Program, click here.
For information specific to VR Transition Services, visit the Missouri Department of Elementary and Secondary Education website on Transition Services.
Eligibility for VR services is determined by the VR counselor on an individual basis. VR specializes in employment and training services that can assist an individual in becoming employed. A VR counselor will determine the individual’s eligibility for services. To be eligible, the individual needs to have a physical or mental impairment that causes problems with working and needs VR services in order to be successfully employed. Once eligible, the individual will work with a counselor who will help to develop a vocational plan. VR will give vocational information and guidance so that the individual will be able to make informed choices about their vocational plan.
For more information about general VR services, visit Missouri Department of Elementary and Secondary Education website on Vocational Rehabilitation.
Independent Living Services
Independent Living is a philosophy and a movement of people with disabilities who work for self-determination, equal opportunities and self-respect. Independent Living does not mean that someone does everything by themselves and does not need anybody or that lives in isolation. Independent Living means that the individual is able to have the same choices and control in their every-day lives that peers without disabilities have. People with disabilities can live independently by being included in the community, in charge of their lives, advocating what they need.
Centers for Independent Living must take the necessary steps to ensure services to persons with disabilities are provided. Centers across the state of Missouri assess the needs of their region on an annual basis. Following, is a list of required core services and additional discretionary services that may be provided. For a listing of Centers for Independent Living in Missouri visit the Missouri Statewide Independent Living Council (MOSILC) website.
The following independent living core services are required:
- Information and referral
- Independent living skills training
- Peer counseling (including cross-disability peer counseling)
- Individual and systems advocacy
In addition to the four core services noted above, the center may provide:
- Counseling Services (including psychological, psychotherapeutic and related services)
- Services related to securing housing or shelter, such as those for community group-living and adaptive housing services (including appropriate accommodations to and modifications of any space used to serve, or be occupied by, individuals with significant disabilities)
- Rehabilitation technology
- Mobility training
- Services and training for individuals with cognitive and sensory disabilities (including life skills training, interpreter and reader services)
- Personal assistance services (including attendant care and training of personnel providing such services),
- Surveys and other activities to identify appropriate housing, recreational opportunities, accessible transportation and other support services,
- Consumer information programs on rehabilitation and independent living services, especially for minorities and other individuals with disabilities who traditionally have not been served or have been underserved
- Education and training necessary for living in the community and participating in community activities
- Supported living
- Transportation (including referral and assistance for such transportation)
- Physical rehabilitation
- Therapeutic treatment
- Provision of needed prostheses or other appliances and devices
- Individual and group social and recreational services
- Training specifically designed for young individuals with significant disabilities, to help them heighten their self-awareness and self-esteem, as well as develop advocacy and self-empowerment skills and explore their career options
- Services for children with significant disabilities
- Services under other federal, state or local programs designed to provide resources training, counseling or other assistance of substantial benefit in enhancing the independence, productivity and quality of life of individuals with significant disabilities
- Appropriate preventive services to decrease the need of individuals with significant disabilities for other services provided by the center
- Community awareness programs to enhance the understanding and integration into society of individuals with disabilities
County Residential Services
In Missouri enabling legislation called SB 40 allows for a county tax levy to be approved by voters for the purpose of establishing residential facilities or related services for the care and employment of individuals with developmental disabilities. Ninety-three percent of the general population live in counties that have a SB 40 tax. Click on this link for more information about SB 40 services in your county.
Families who have children with special needs want them to have quality care throughout their life. Navigating through the maze of legal and financial bureaucracy can be a daunting task when trying to plan financially for the future. Families may want to pursue establishing a Special Needs Trust. Missouri Developmental Disability Resource Center has a list of resources for financial planning.