FAQ

The expectation is that providers involved with SOAR do not charge persons applying for SSA disability benefits for their services. We work closely with providers to identify alternative sources of funding for their programs. All 50 states and the District of Columbia have identified various methods to fund SOAR activities that do not involve charging the applicant or collecting a fee from the applicant’s back pay. Resources related to SOAR funding and sustainability can be found in the SOAR Library.

The SOAR TA Center does not have funds available to pay for SOAR in local organizations and there is no dedicated source of funding for SOAR programs. And yet, all 50 states participate in SOAR at some level by reallocating existing resources; by securing funding through federal and state grants or foundation funding; or by establishing collaborations with hospitals and criminal justice systems.

To support local organizations, the SOAR TA Center developed resources and tools for funding and sustainability, based on best practices from SOAR programs around the country. The SOAR TA Center also maintains a webpage dedicated to upcoming funding opportunities, which is updated frequently with new resources.

1619(b) is continued Medicaid coverage for those individuals that were receiving SSI benefits prior to returning to work. You can find more information on SSA's website here: http://www.socialsecurity.gov/disabilityresearch/wi/1619b.htm

Most SOAR programs that have a hospital collaboration will work with the hospital’s billing department to collect information on reimbursed expenses for each SOAR applicant approved. Some are able to separate out Medicaid and Medicare reimbursements; others have just a total for all reimbursements. The information isn't any more complicated than: "We helped 100 individuals get approved for SSI/SSDI and the hospital has been reimbursed $500,000 in the past year in Medicaid/Medicare expenses for these individuals."  It can be helpful to also collect the totals for unreimbursed expenses for those same individuals for the year prior to approval to use as a comparison.  One SOAR provider looked at emergency room usage for the year prior and the year after approval to see if there was a reduction. They found a 24 percent reduction in ER usage and 52 percent reduction in psychiatric ER usage.

Some SOAR providers will meet monthly with the billing department and collect reimbursement data, others will do it quarterly.  We would recommend doing whatever works best for the staff at the hospital and the SOAR staff.  

If a person is approved for both SSI and SSDI they will maintain Medicaid because SSI benefits include Medicaid. However, some states require a separate Medicaid application, (https://www.ssa.gov/disabilityresearch/wi/medicaid.htm).

Medicaid coverage for services varies from state to state. Here is a link that will take you to your state's Medicaid agency: https://www.medicaid.gov/about-us/contact-us/contact-state-page.html.

SSDI benefits include Medicare, but there is typically a 24 month waiting period before the SSDI beneficiary can begin to have Medicare coverage (see Page 12 at https://www.ssa.gov/pubs/EN-05-10029.pdf).

Once the beneficiary has both Medicaid and Medicare, Medicare is typically the primary insurance.