Health care is an important issue for men and women of all ages. If you are also disabled, having health care coverage may be a matter of life and death for you. As a disabled individual you have several health care options in the state of Massachusetts, the two main programs being Medicare and MassHealth.
Definition of Disability
According to the government, if you have a severe mental or physical condition that has lasted or will last at least 12 months or more or result in death, you are considered disabled. A child is disabled if her condition prevents her from participating in age-appropriate activities, or if the same condition would disable an adult.
By government definition, as pointed out on the website MassResources, a disabled adult is 18 or older and has a mental or physical condition that prevents him from doing gainful work. If you are disabled and working at least 40 hours a month, you are considered a disabled working adult.
Medicare
If you are under 65 but have a disability you might qualify for Medicare. After you apply and hold Social Security Disability Insurance for 24 months, you can enroll in Medicare.
MassHealth Eligibility
If the Social Security Administration (SSA) or the state's Division of Medical Assistance's Disability Determination Unit (DDU) determines you are indeed disabled, or you get a certification of legal blindness from the Massachusetts Commission for the Blind, you are considered disabled for MassHealth eligibility.
MassHealth is available for low and medium-income residents of Massachusetts under certain conditions. MassHealth has nine related programs, some of which provide coverage for the disabled.
MassHealth Standard
You will receive full range health-care benefits if you are disabled as defined by the federal government. Your premium depends on your diagnosis, the age of your children and/or caretaker and your income.
MassHealth CommonHealth
Those who do not qualify for coverage under the MassHealth Standard program can get insurance through MassHealth CommonHealth. The program is available for disabled children under 18. It is also available to disabled adults who: work 40 or more hours a month; or are under age 65 and not working; or are working and meet specific state and federal rules.
There is no income limit to be considered for the program. If your income exceeds 100 percent of the federal poverty level before taxes and deductions, a premium may be charged for disabled children or you might have to pay a one-time-only deductible for them. Disabled working adults need to pay a monthly premium depending on gross income.
MassHealth Essential
If you are not eligible for the MassHealth basic program, you could receive coverage through MassHealth Essential if you are disabled according to MassHealth standards. You must also be under age 65, not working and not collecting unemployment.
MassHealth Limited
Individuals who are disabled according to federal standards, as well as parents living with their disabled children under age 19 who cannot receive services because of their immigration status, can get emergency health services through the MassHealth Limited program.
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