Arc Fact Sheet on Dual Eligibles with Developmental Disabilities
Everyday, both Family to Family and Illinois Life Span programs at The Arc of
Illinoisare being contacted daily by families and providers regarding these issues
so we have developed this fact sheet to assist you..
Tony
Family Manual Fact Sheet
Focus on Dual Eligibles with Developmental Disabilities
August 2014
Who are Dual Eligibles – also referred to as “Duals”?
Dual Eligibles are persons who receive health benefits from both Medicare and
Medicaid. Please note that we are referring to individuals with developmental
disabilities for the purposes of this Fact Sheet.
Many individuals with developmental disabilities also receive financial benefits
from SSDI and/or SSI. This is an important piece of information because that
financial benefit can impact the health/medical benefits received through
Medicare and Medicaid.
For more information on SSI and SSDI, please click on the following link to
view a chart comparing the two programs, created by Health & Disability
Advocates and the Make Medicare Work Coalition:
How might an individual with disabilities qualify for SSDI?
Persons who are eligible for SSDI can be eligible based upon their own work
history, or their status as a Disabled Adult Child of a worker who is disabled/
retired/deceased: http://www.ssa.gov/dibplan/dqualify10.htm#age22
An adult disabled before age 22 may be eligible for child’s SSDI benefits if a
parent is deceased or starts receiving retirement or disability benefits. We
consider this a “child’s” benefit because it is paid on a parent’s Social Security
earnings record. The “adult child”—including an adopted child, or, in some cases,
a stepchild, grandchild, or step grandchild—must be unmarried, age 18 or older,
and have a disability that started before age 22.
What is the MMAI, or Medicare-Medicaid Alignment Initiative, also called
the Dual Eligibles program?
Tony Paulauski Executive Director
The Arc of Illinois
20901 S. LaGrange Rd. Suite 209
Frankfort, IL 60423
815-464-1832 (OFFICE)
815-464-1832 (CELL)
Tony@www.thearcofil.org
