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Understanding Government Programs.  Waiver Programs and More…..

United Spinal Association of Northeast Ohio > BLOG > Connections Newsletter Article > Understanding Government Programs.  Waiver Programs and More…..

By Matthew Riley, LISW

There is often confusion about Social Security and Supplemental Security Income  (SSI) because you apply for both programs with the Social Security Administration.  But the programs are different.  The Social Security benefit programs are “entitlement” programs. This means that workers, employers, and the self-employed pay for the benefits with their Social Security taxes.  The taxes that are collected are put into a special trust fund.  The amount of the benefit is based on these earnings. Individuals who reach full retirement age and workers, who have become disabled and may not be able to return to employment, are eligible for Social Security.

SSI is a needs-based program for people with limited income and resources.  Individuals become eligible for SSI when their resources are below a certain limit.  The program is paid for by general tax revenues – not from the Social Security Trust funds.  The benefit amount is based on Federal and State laws, which consider where you live, who lives with you, and what income you receive. 

Social Security Disability Insurance (SSDI) is provided to those who are made eligible through the Bureau of Disability Determination.  An individual’s specific disability is evaluated through a set of criteria that are used to determine if a person is able to return to a job that will provide them with a living wage.  This job does not always have to be what they did before and can be another occupation they may be qualified for based on their skills and limitations.  When an individual is found eligible for SSDI, their benefit is calculated on how much they have paid in Social Security taxes. An individual with a disability, who would like to return to work after they have been made eligible for SSDI or have not been found eligible for benefits, can access a State agency, Opportunites for Ohioans with Disabilities (OOD), for services.  This agency provides assistance to identify employment opportunites, secure a job in the community, and the resources to learn and maintain that job.  

Social Security representatives are your best source for information regarding eligibility and benefits.  Representatives can be reached toll-free at 1-800-772-1213.  You can also access Social Security through their website .

Health care has traditionally been tied to employment, and in 1965 President Lyndon Johnson signed an amendment to the Social Security Act, which established Medicare and Medicaid.  Medicare is an insurance program. Medical bills are paid from trust funds which those covered have paid into. It serves people over 65 primarily, whatever their income, and serves younger disabled people and dialysis patients. Patients pay part of the costs through deductibles for hospital and other costs. Small monthly premiums are required for non-hospital coverage.

Medicare is a federal program. It is basically the same everywhere in the United States and is run by the Centers for Medicare & Medicaid Services, an agency of the federal government. Medicaid is an assistance program. It serves low-income people of every age. Patients usually pay no part of the costs for covered medical expenses. A small co-payment is sometimes required. Medicaid is a federal-state program. It varies from state to state. It is run by state and local governments within federal guidelines. Medicaid also provides for demonstration programs that address specific populations who may need long-term services and support.  These programs, called waivers, are designed to assist individuals in living in their homes and remain active in their communities. For more information about Medicare, contact  Medicaid can be contacted at

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