FAQ

Benefits planning is the process of assessing the options that are available to achieve a goal regarding benefits and then finding the best route to achieve the goal. To accomplish this, we dive deeply into benefits policies and details regarding our clients’ situation and goals in order to understand the full extent of the options available. Then, we take into account of all of the parties or entities involved and their roles. We also examine and plan for challenges and roadblocks. The end result is the creation of a “map” that includes the best path for achieving the goal.

Benefits counseling occurs after the planning stage. The goal of counseling is to helps clients better understand and navigate benefits programs.

Education involves communicating important information and aspects of the situation at a level of detail that our clients are comfortable with. Specifically, we communicate information regarding the steps that are necessary to achieve to achieve one’s goals, and any issues that we may need to troubleshoot along the way. In many cases, we need to inform clients of the various parties or entities involved and their roles so that they better understand who is doing what and why, and how that figures into the plan.

Coaching means we provide guidance on how to best achieve our clients’ goals, as well as the steps, behaviors, habits, that are necessary for clients to achieve their goals.

Advocacy, for us, means we act on your behalf. It consists of communicating with private or government entities on your behalf and acting as your representative. This often makes parts of the process much more efficient as we are familiar with who to speak and about what in order to get things moving in the rights direction. We are also fluent in the policy lingo of government and private entities, which often confuses most citizens (including us, when we were on benefits). In order to communicate and act on your behalf, we need your permission through written forms and/or documents (or verbal consent, in some situations).

Fun Fact: The “ACE” in “The Benefit ACE” refers to the three skills we engage in when interacting with our clients: Advocacy, Coaching, and Education.

Yes, we are experts in assisting with and planning for multiple benefits!

For folks who are on SSI, SSDI, Medicaid, Medicaid waivers, Medicare (all parts), or any combination of such benefits: one of the major challenges is keeping track of eligibility requirement for multiple programs. If you lose sight of the requirements, you may unexpectedly lose benefits, as many of our clients have unfortunately experienced. As a result, that can lead to dramatic changes in both your access healthcare and your financial stability. 

If you like to do some or all of the process yourself, our role is to create a solid plan help you maintain eligibility, inform you of your options, and give you guidance on the best of course of action to meet your needs and goals.

To further reduce stress during the process of navigating multiple benefits, some clients hire us to do most of the work and even act on their behalf regarding benefits. In such cases, we inform them and provide guidance only so often throughout the process so they are less stressed but still receive important updates and details.

Yes, you can receive personal care, respite care, and more through two waivers: the Intellectual and Developmental Disability (DD) Waiver and the CCC Plus Waiver. These are also referred to as long-term services and supports (LTSS). These waiver programs provide additional benefits, such as assistive technology, environmental modifications, and more. The DD waiver is better suited for individuals with intellectual and developmental disabilities, which is why it offers a wide array of covered services in additional to personal and respite care.

Through a Medicaid work-incentive program called Medicaid Works, you can receive personal care services, as well. This program that can increase financial stability and independence for disabled folks who want to work. Folks enrolled in this program cannot be enrolled in the other waiver programs, though.

Each program and waiver has its own unique eligibility requirements and timelines that can affect one’s plan regarding healthcare, work, income, resources, and more.

Fun fact: if you are waiting for a DD waiver slot, you can participate in personal and respite care through the CCC Plus Waiver. DD waivers have limited slots and folks applying for them often experience a waiting period that may last years. The CCC Plus waiver does not have a waiting period, though.

We would be happy to fight for you in a case against reduced care hours. We have plenty of experience (and success) with such appeals.

While we can’t guarantee that you will get your care hours back, we will 1) assess your needs and goals, 2) compare them with the policies regarding care hours, 3) determine the range of hours you are eligible for, and 4) file an appeal on your behalf. In some situations, we can ask for more hours than you were originally approved for, especially if you were initially approved for fewer hours than you deserve.

If we don’t feel like we can assist you with your case, we will refer you to someone who hopefully can.

Yes, but only if you meet the eligibility requirements for them.

Depending on the waiver you are changing to or from, your ability to switch back may not be easy. We can help you plan for changes and consider your options to determine what best suits your needs and what steps are necessary to achieve your goals.

Absolutely! The Social Security Administration has various work incentive programs for individuals receiving SSI and SSDI.

Of course, income and asset/resource limits must be considered so that you remain eligible. However, there are several ways to earn more and maintain eligibility while improving your financial stability. For SSI (and Medicaid), there are also options available to protect your assets/resources so that you don’t unexpectedly lose your benefits.

Yes, you can. In fact, there is a specific work-incentive group called Medicaid Works that allows individuals to greatly increase the limits of both earned income and savings without endangering eligibility.  You can even receive personal care services while enrolled in Medicaid Works!

You don’t have to participate in Medicaid Works to work and still remain eligible Medicaid. There are other routes that can be taken, some of which depend on whether you are on SSI, SSDI, or both.