Can I Replace My Income with MS Disability Insurance? - dummies

Can I Replace My Income with MS Disability Insurance?

By Rosalind Kalb, Barbara Giesser, Kathleen Costello

Whereas health insurance helps pay for both your general and your multiple sclerosis-related (MS) healthcare costs, disability insurance helps replace your income if you become too disabled to earn a living. You can purchase disability insurance on your own. Some employers offer disability insurance (through a commercial insurance company) to their employees as a benefit.

In addition to this type of commercial insurance, the federal government provides public disability insurance through programs administered by the Social Security Administration (SSA). These programs are financed via the taxes paid by workers and employers.

Commercial and public disability plans define “disability” differently. Both, however, put the burden of proving your disability on you and your doctor.

MS and commercial disability insurance

Commercial disability insurance (as distinguished from public disability insurance) is available through some employers or may be purchased privately to protect you in the event that you become unable to continue in your current job because of a disability. Because every commercial disability policy is a contract, the definition of “disability” can vary a lot depending on the terms of that contract. So, don’t make any assumptions about your coverage. Take the time to familiarize yourself with your policy’s definitions and conditions early on — well before you ever consider filing a claim.

After you’ve been diagnosed with MS it can be difficult (if not impossible) to qualify for commercial disability insurance. Employers may offer it, but the insurance companies may not be willing to take you on. If you decide to try and buy it on your own, it may help to work through an insurance broker or to speak with someone in the underwriting department (rather than the sales department) of an insurance company because the underwriting folks are less likely than the sales folks to turn you down outright. If you’ve already been diagnosed, the chances of approval will probably depend on how well you’re doing when you apply.

Never lie about your medical condition or history on an application for insurance! Don’t volunteer anything you aren’t asked for, but don’t commit fraud by providing inaccurate information — doing so will seriously jeopardize your ability to buy any type of insurance ever again.

Even if you have commercial disability insurance, you can still apply for benefits from SSA (more on that in a moment). In fact, commercial insurers are eager to transition disabled policyholders into Social Security Disability Insurance (SSDI) and are likely to require you to file the application.

MS and public disability insurance: SSDI

The main public disability insurance you need to be aware of is Social Security Disability Insurance (SSDI). SSDI pays benefits to you and certain members of your family if you’re insured, meaning that you worked and paid Social Security taxes for a sufficient period of time.

The eligibility criteria for SSDI are clearly defined in the law, and this program is strictly for those who are unable to be gainfully employed because of a physical or mental impairment that lasts at least 12 months.

An impairment isn’t simply a diagnosis of a disease or condition; it’s a measure of how impaired one is as a result of that disease or condition. Check out the SSA website for lots of helpful information about the eligibility criteria and the application process.

If you’re considering applying for SSDI benefits, review the eligible MS-related impairments (vision, walking, cognitive problems, and fatigue) carefully and honestly with your doctor to make sure that you’re in agreement about which may apply to you.

To help with this discussion, take a look at the SSDI toolkit on the National MS Society website. The components of the kit will help you understand the application process and the criteria used by the SSA. The kit also provides you and your doctor with the instructions and template letters you need to file an effective application.

The SSA will notify you in writing when you’ve been deemed disabled, and it will provide the exact start date of the disability. Beginning with that start date, you’ll have a waiting period of five months until the payment of benefits begins. Make sure you factor this waiting time into your financial planning.

Twenty-four months after your SSDI benefits begin (29 months after the onset of disability) you’ll automatically qualify for Medicare. Contact Medicare online or at (800) MEDICARE (800-633-4227) if you don’t receive information regarding the program before your 29th month of disability.

The move to Medicare coverage (from your group insurance plan or from COBRA) is another critically important transition period for your personal financial planning because you’ll need to make important decisions about your coverage, including your prescription drug plan.

People with disabilities who gain eligibility for Medicare when they’re under 65 must make all the same choices about their Medicare benefits as those who retire into the program. So, if this is you, go to the Medicare website and click on “Compare Medicare Prescription Drug Plans” to get started. And don’t hesitate to contact the National MS Society by calling (800) FIGHT-MS (800-344-4867) if you need to consult with someone about your options.

Finally, keep in mind that the Social Security Administration offers incentives to people who think they may want to try returning to the workforce. You can return to work on a trial basis (referred to as a trial work period) without jeopardizing your eligibility for benefits. Check out more information about SSA’s work incentives on their website.