Medicaid and SSI denied..? - Down Syndrome Message Board

prjr99 · 08-01-2005, 04:46 PM

My question is this... if you have DS, are you automatically entitled to SSI and medicaid no matter what type of income your family makes?

My family's having problems with that. Not because they make too much money, but because my dad receives Social Security money for his own disability and they denied my sister's claim (she has down syndrome) for SSI... for reasons I don't understand because our income isn't high at all. My mom isn't very helpful about the whole situation. We moved to Florida about a year ago and no health insurance company will have someone with Down Syndrome

we need Medicaid and SSI, but I've heard so many things I don't know what to believe anymore about this. Anyone got any suggestions?

Karen W. · 08-02-2005, 09:43 PM

Hi,
I don't know the laws of Florida but I do have a girlfriend who is getting SSI, She has a daughter who is 9 years old. Becuase she has a daughter who is under the age of 18 years of age, she has money added to her SSI check to help support her. So your Father is on SSI, he may be getting extra money added to his check because she is under 18. That is how it is in Wisconsin. Now I was not able to get SSI for my son because we both work and we maid to much money-( they say), frankly I felt we should have recieved something, even child care would have been nice. My son is down syndrom and I carry him on my health Insurance threw my work, I have never had a problem.
Karen W.

prjr99 · 08-03-2005, 07:45 AM

You have him on your health insurance? Hm. In Florida, I've been told (by a health insurance agent guy) that most (if any) insurance companies won't cover Down Syndrome kids. Only medicaid will. I don't understand why... maybe they think its too big a risk or something? I don't know. Weird..

-Jose

Karen W. · 08-03-2005, 11:25 PM

Hi,
Since my son was born, we have had compcare, bluecross/blueshield, humana and right now we have united health care, never had a problem. There is a law, If a parent carries health insurance, by law a health insurance company cannot deny him or her with a disabilty. My son is now 19 years old, The law also states that if he is unable to take care of himself, he can remain on my health insurance no matter what age he is. I recently found this out because my son was dropped from my health insurance, they said they would not cover him because he was not a full time student. Well, I was told by a social worker at the hospital, that they cannot do that, there breaking the law, She had called United health care and did a three way call so I could here it, she had a talk with them and they fixed the problem-(they said they didn't know he was DS) and now he is 100% covered. I also have a few friend who have kids with disabilities, they are also covered by insurance.
Karen

jessicap3 · 08-04-2005, 05:59 PM

Hi just wanted to give my experience with this also. I have a 2 1/2 year old daughter with DS. We live in CA and she is considered disabled however we cannot collect it for her because of my income. Also our law states that when she is 18 years old she is elible ONLY if she does not have more than $2,000.00 in assests. The whole program is not fair for our kids. My girl also does not qualify for insurance thru her disability because of that same money issue. Which makes the SSI program only useful if you are extremely poor. We definately need reform in these programs for kids. The money is not an issue for us however the insurance is. I am now going to insure her thru my work because it is an HMO and we can insure people with preigisting conditions. A private policy will not insure her because she is considered uninsurable. I know the problems so well that you all face because my daughter has had health issues realated to her Downs that have cost major $$ in hospital stays.

Good luck to you...

Jessica