Quick Guide: Understanding Programs and Benefits for People with Disabilities

Along with the daily challenges of living with a disability, many individuals face the added weight of financial strain.

“Not only do people living with disabilities face higher rates of unemployment and lower wages, but the cost of living with a disability is also higher, requiring about 29% more income than a household without a disability,” says Jody Ellis, Director of the ABLE National Resource Center, managed by National Disability Institute. These additional costs, whether from healthcare, assistive technology, transportation, or caregiving, can make achieving financial stability difficult without support.

Fortunately, several programs and benefits are available to ease the financial burden of living with disabilities. Learning about these resources and understanding how they work can empower individuals and families to build independence and long-term security.

Here are some programs worth knowing about.

Financial programs

ABLE Accounts

ABLE stands for Achieving a Better Life Experience, and these versatile accounts allow people with disabilities to save without losing benefits. Funds grow tax-free and help protect assets from Medicaid and SSI resource limits, giving families flexibility and independence.

Funds up to $100,000 are not counted toward SSI assets and do not affect SSI benefits. Any amount of ABLE funds, up to the plan’s balance limit, is not counted as a resource for other public benefit programs (i.e., HUD, Medicaid, and SNAP)

“ABLE accounts open doors for opportunities, creating independence, promoting financial and community inclusion, and supporting financial empowerment,” Jody says.

Good to know:

• The ABLE account annual contribution limit is $20,000 in 2026 (higher for employed account holders).
• ABLE account funds may be used for qualified disability expenses (QDEs) and must benefit the account owner.
• Currently, a person is eligible for an ABLE account if their qualified disability began before age 26. However, on Jan. 1, 2026, eligibility will expand to anyone whose qualified disability began before age 46.

Special Needs Trusts

Special needs trusts (SNTs) protect inheritance, gifts, and larger sums while preserving eligibility for benefits. Unlike ABLE accounts, trusts do not have an annual contribution limit and are managed by a trustee.

There are two types of special needs trusts:

• First-party SNTs, funded with the beneficiary’s own assets (such as a settlement or back payment), must include a Medicaid payback provision.
• Third-party SNTs, funded by parents, relatives, or others, do not require Medicaid payback and can pass remaining funds to other heirs.

“Parents shouldn’t be leaving money in their child’s first-party trust — they need to set up a third-party trust,” says Bruce Sham, CLF, an advanced special care planner and founder of Special Journey Solutions.

As the father of a child with special needs, Bruce has firsthand experience with setting up a third-party SNT. “I’m leaving money to my daughter to supplement what she’s getting from government services, and it does not count against her,” he says. “She can’t touch the money directly — there’s a trustee who’s responsible for it, and they can only use it for her health, maintenance, and support.”

Good to know:

• SNT funds must be used for the beneficiary’s sole benefit. Even gifts or shared household items should be justified as benefiting the individual with disabilities.
• Money in an SNT cannot be paid directly to the beneficiary in cash or cash equivalents (like gift cards), or it will count as income and could jeopardize SSI and Medicaid eligibility.
• If the SNT pays for food or housing (such as groceries, rent, or mortgage payments), SSI benefits may be reduced because these are considered “in-kind support and maintenance.”
• SNTs and ABLE accounts can work together. For example, if a person received a sum higher than the ABLE annual contribution limit, they could save the excess in a trust account. Money from an SNT can also be deposited into an ABLE account. Housing expenses can be paid with ABLE funds without impacting the account owner’s monthly SSI payment amount.
• Some states require annual accountings or approval of trustee fees. Check your state’s SNT rules for specific requirements.

Tax deductions

Families managing disability-related expenses may qualify for various federal tax deductions and credits.

Good to know:

• Travel and lodging for medical care may qualify as deductible expenses. “Families often don’t realize that if they’re traveling to a conference, the hotel and the tickets are deductible expenses. Mileage is also deductible if you’re driving for medical care,” Bruce says.
• Always consult a tax professional familiar with disability-related deductions to ensure compliance and maximize your returns.
• For tips on finding a financial professional well-versed in disability considerations, read Financial Education and Planning Help You Take Charge of Your Financial Future.

Benefits programs

Children’s Health Insurance Program (CHIP)

CHIP provides low-cost or free health insurance coverage for children whose families earn too much to qualify for Medicaid but still need help affording care. It covers essentials such as doctor visits, prescriptions, hospital care, and, sometimes, dental or vision services.

Each state runs its own CHIP program, so benefits and cost-sharing rules differ. (Families can find details through their state’s Medicaid or CHIP office.) Most states cover children in families earning up to 200-300% of the Federal Poverty Level (FPL). For 2025, that’s about $62,000-$93,000 for a family of four.

Good to know:

• Many families pay no insurance premiums. When premiums apply, they’re often $0-$50 per child per month, with total costs capped at 5% of family income per year.
• States may charge small copays for office or ER visits, but preventive care (like checkups and vaccines) must be free.
• Children usually remain covered even if family income rises slightly, helping ensure consistent access to care.
• CHIP often works hand in hand with Medicaid to help ensure children get the care they need.

Medicaid

​​Medicaid is a joint federal and state health insurance program that helps people with limited income access essential care. For many people living with neuromuscular diseases, Medicaid provides necessary security, covering drugs, caregiving/home health, and hospital care that would otherwise be unaffordable.

The strict $2,000 asset limit can make financial planning tricky.

Good to know:

• Pensions, savings bonds, insurance policies, and, in some cases, even 529 college savings plans, can count toward the $2,000 asset limit.
• Once a child is 18, Medicaid looks at all their income and resources.
• It’s important not to confuse Medicaid with Medicare, which is a federal health insurance program for people 65 or older and people with disabilities. Enrolling in some Medicare Advantage plans can disqualify someone from essential Medicaid benefits. In addition, Medicaid offers benefits that Medicare typically doesn’t cover, such as personal care services.

Medicaid Buy-In and HIBI Programs

Some states offer Medicaid Buy-In or Health Insurance Buy-In (HIBI) programs that allow working individuals with disabilities to maintain Medicaid coverage while earning an income. These programs can make private insurance coverage affordable while preserving essential Medicaid services.

“HIBI pays my premium, my deductible, my copay — Medicaid is covering it. It’s a huge help,” says Lyza Weisman, a law student from Colorado who lives with spinal muscular atrophy (SMA).

Good to know:

• Most states set income limits around 200-300% of the Federal Poverty Level (about $62,000-$93,000 for a family of four in 2025), but some state programs waive or raise asset limits.
• Monthly premiums or sliding-scale payments may apply, often modest compared to private insurance.
• HIBI programs may pay for part or all of a private insurance plan’s premiums, deductibles, and copays, keeping out-of-pocket costs very low.
• Check with your state Medicaid agency for specific availability and rules.

State Medicaid Waiver Services

State-specific waiver programs expand Medicaid coverage to services not typically included under standard plans, such as personal care, respite care, rehabilitation services, caregiving, behavioral supports, assistive technology, vehicle or home modifications, and employment assistance.

Requirements vary, but most waivers are for people who meet the level of care required to qualify for care in a nursing home or similar facility. Waiver programs are intended to help individuals avoid institutional care and remain in their communities.

Good to know:

• Some waiver programs allow participants to qualify based only on their individual income, not household income. This makes it easier for children or adults with disabilities to qualify even if parents or spouses earn more.
• Some waivers will compensate family caregivers, such as parents or spouses.
• Waivers often have waitlists, so applying early is crucial.
• Learn about your state’s waiver programs by visiting the Medicaid State Waivers List or searching for your state’s Department of Health or Human Services website.

Supplemental Security Income (SSI)

The Social Security Administration offers two main disability benefit programs: Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI). (Read on for information on SSDI.)

SSI provides monthly payments to individuals with disabilities who have limited income and resources. It’s often the first program that young adults with disabilities qualify for upon turning 18.

For children under 18 to be eligible, the child and parents must meet disability and income rules. The maximum monthly SSI payment in 2025 is $967 for an individual and $1,450 for a couple, although the exact amount can vary by state and is based on income and other factors.

Good to know:

• SSI benefits may be impacted by savings and income, but programs like ABLE accounts (see the section on ABLE accounts above) can help preserve eligibility.
• Families should track earnings carefully because overpayments may occur if their income increases and the increase isn’t reported right away.

Social Security Disability Insurance (SSDI)

SSDI supports individuals who have worked and paid Social Security taxes, as well as certain dependents of retirees or deceased workers.

Young adults with a disability between the ages of 18 and 22 may continue receiving benefits under special provisions if a parent is deceased, retired, or receiving Social Security. Additionally, children who qualify before age 22 can later receive half of a parent’s retirement benefit. “This means that if I’m retired and getting $3,000, my daughter may be eligible for $1,500,” Bruce says.

Good to know:

• The SSDI application process can be lengthy, often resulting in a delay between the initial application and benefits approval. In this case, recipients can apply for back payments for the months they were eligible but had not yet been approved.
• SSDI recipients should also be aware that they may owe repayments if they continue to receive benefits when they are not eligible. “If you get a job, it can take them three to four months to stop payments, but you do owe that money back,” cautions Lyza.

Vocational Rehabilitation (VR)

VR programs, which are typically run through a state’s Department of Education or Labor, help participants with disabilities prepare for, obtain, and retain employment. They offer assistance in paying for education, training, assistive technology, vehicle modifications, and professional coaching.

Lyza Weisman credits VR with making her legal career possible. “They helped me pay for law school, get my desk, phone, software, and my vehicle modification, which was $126,000,” she says. “Altogether, they’ve given me over $250,000.”

Good to know:

• VR isn’t just for job seekers. They can also assist if you’re already employed and develop a new disability or need workplace accommodations.
• VR counselors often coordinate with schools, employers, or community agencies to help create a personalized employment plan that aligns with your goals and strengths.
• Every state has a VR office or agency. Find yours through the State Vocational Rehabilitation Agencies directory on the US Department of Education’s Rehabilitation Services Administration website.