People with Spina Bifida in California can access federal and state disability benefits, including SSI, SSDI, Medicaid waivers, and ABLE accounts. This guide explains eligibility, how to apply, and key changes for 2025.
SSI (Supplemental Security Income): SSI is for people with limited income and resources who are disabled, blind, or age 65 or older. Spina Bifida is considered a disability if it meets Social Security's definition. The federal SSI payment in 2025 is $943/month for an individual and $1,415/month for a couple. Some states add a supplement; California does not, but provides other support.
SSDI (Social Security Disability Insurance): SSDI is for people who have worked and paid Social Security taxes. Spina Bifida qualifies if it meets the disability criteria. The average SSDI payment in 2025 is about $1,450/month, with a maximum of $4,018/month. The amount depends on your work history.
Medicaid: Medicaid provides health coverage for people with disabilities. Eligibility is based on income and resources. People with Spina Bifida may qualify for Medicaid if they meet the criteria.
Medicare: Medicare is health insurance for people 65 or older, or those who have received SSDI for 24 months. People with Spina Bifida who get SSDI will qualify for Medicare after 24 months.
Work Incentives: There are programs to help people with disabilities work without losing benefits. For example, the Trial Work Period allows SSDI recipients to test their ability to work without losing benefits.
Children: Children with Spina Bifida may qualify for SSI or SSDI if a parent is disabled, retired, or deceased. Benefits for children stop at age 18 unless they are disabled or a full-time student.
Adults with Childhood Disability: Adults whose disability began before age 22 may qualify for SSDI on a parent's record if the parent is retired, disabled, or deceased.
Substantial Gainful Activity (SGA): In 2025, the SGA limit is $1,620/month ($2,700 if blind). Earning more than this may affect eligibility for SSI and SSDI.
Work Credits: To qualify for SSDI, you need a certain number of work credits. In 2025, you earn 1 credit for each $1,810 in wages or self-employment income, up to 4 credits per year.
Federal Benefits: Apply for SSI and SSDI online at ssa.gov, by phone at 1-800-772-1213, or in person at a Social Security office.
California SDI/PFL: Apply online at edd.ca.gov or by phone at 1-800-480-3287.
Medicaid: Apply online at coveredca.com or in person at your county social services agency.
Medicaid Waivers: Contact your local regional center or county social services agency.
California Children's Services: Contact your local county health department or regional center.
In-Home Supportive Services: Contact your county social services agency.
Regional Centers: Contact your local regional center.
Work Incentives: Contact a WIPA counselor or the Ticket to Work Help Line at 1-866-968-7842.
Step 1: Gather Documents
Step 2: Apply for Federal Benefits
Step 3: Apply for California SDI/PFL
Step 4: Apply for Medicaid
SSI (Supplemental Security Income): Provides monthly cash payments to people with disabilities who have limited income and resources.
SSDI (Social Security Disability Insurance): Provides monthly cash payments to people with disabilities who have worked and paid Social Security taxes.
Medicaid: Provides health coverage for people with disabilities.
Medicare: Provides health insurance for people with disabilities who have received SSDI for 24 months.
Medicaid Waivers (HCBS): Provides home and community-based services for people with disabilities.
Work Incentives: Programs to help people with disabilities work without losing benefits.
Children's Benefits: Benefits for children with disabilities.
Adults with Childhood Disability: Benefits for adults whose disability began before age 22 on a parent's record.
California State Disability Insurance (SDI): Provides short-term wage replacement for people who cannot work due to a non-work-related illness or injury, including Spina Bifida. In 2025, the maximum weekly benefit is $1,681. SDI benefits are calculated as 70% or 90% of wages.
Paid Family Leave (PFL): Provides wage replacement for people who need to care for a seriously ill family member, bond with a new child, or participate in a qualifying event due to a family member's military deployment. PFL benefits are also calculated as 70% or 90% of wages, with the same maximum weekly benefit as SDI.
Medicaid Waivers (HCBS): California offers Medicaid waivers for home and community-based services. These waivers can help people with Spina Bifida live in their communities instead of institutions. Waivers may cover services like personal care, respite care, and home modifications.
California Children's Services (CCS): CCS provides medical care and support for children with certain chronic conditions, including Spina Bifida. CCS covers diagnosis, treatment, and rehabilitation services.
ABLE Accounts: ABLE accounts allow people with disabilities to save money without losing eligibility for SSI and Medicaid. In California, the ABLE account is called CalABLE. You can save up to $18,000 per year in 2025. The account can be used for disability-related expenses like education, housing, transportation, and personal support services.
Eligibility: To open a CalABLE account, you must have a disability that began before age 26 and meet the Social Security definition of disability.
Benefits: ABLE accounts do not affect SSI or Medicaid eligibility as long as the balance is below $100,000. If the balance exceeds $100,000, SSI payments are suspended, but Medicaid coverage continues.
How to Apply: You can apply for a CalABLE account online at calable.org or by phone at 1-800-222-2228.
SSI: The federal SSI payment in 2025 is $943/month for an individual and $1,415/month for a couple. California does not add a state supplement. The resource limit is $2,000 for an individual and $3,000 for a couple.
SSDI: There is no income limit for SSDI, but the amount depends on your work history. The maximum monthly benefit in 2025 is $4,018.
Medicaid: Income limits for Medicaid vary by program. For most programs, the limit is 138% of the federal poverty level.
Medicaid Waivers: Income limits for Medicaid waivers vary by program. Some waivers have higher income limits.
California SDI/PFL: There is no income limit for SDI/PFL, but benefits are calculated as 70% or 90% of wages, up to a maximum of $1,681 per week in 2025.
ABLE Accounts: You can save up to $18,000 per year in 2025 in an ABLE account. The account balance does not affect SSI or Medicaid eligibility as long as it is below $100,000.
Reporting Changes: It is important to report changes in income, resources, or living situation to avoid overpayments and ensure you receive the correct benefits.
People with Spina Bifida in California can qualify for SSI, SSDI, Medicaid, and Medicare. SSI is for those with limited income and resources. SSDI is for those who have worked and paid Social Security taxes. Medicaid provides health coverage, and Medicare is available after 24 months of SSDI.
California offers State Disability Insurance (SDI), Paid Family Leave (PFL), Medicaid waivers, California Children's Services (CCS), In-Home Supportive Services (IHSS), and regional center services. These programs provide wage replacement, health care, and support services.
You can apply for SSI and SSDI online at ssa.gov, by phone at 1-800-772-1213, or in person at a Social Security office. You will need to provide proof of identity, disability, income, and resources.
You can apply for SDI and PFL online at edd.ca.gov or by phone at 1-800-480-3287. You will need to provide proof of identity, disability, income, and resources.
The federal SSI payment in 2025 is $943/month for an individual and $1,415/month for a couple. There is no income limit for SSDI, but the amount depends on your work history. The maximum monthly benefit in 2025 is $4,018.
This guide is for informational purposes only and is not legal or financial advice. Always consult with a qualified professional for personalized guidance.
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California State Disability Insurance (SDI): SDI provides short-term wage replacement for people who cannot work due to a non-work-related illness or injury, including Spina Bifida. In 2025, the maximum weekly benefit is $1,681. SDI benefits are calculated as 70% or 90% of wages, up from 60% or 70% in previous years. The payroll contribution rate is 1.2% of earnings, with no wage cap.
Paid Family Leave (PFL): PFL provides wage replacement for people who need to care for a seriously ill family member, bond with a new child, or participate in a qualifying event due to a family member's military deployment. PFL benefits are also calculated as 70% or 90% of wages, with the same maximum weekly benefit as SDI.
Medicaid Waivers (HCBS): California offers Medicaid waivers for home and community-based services. These waivers can help people with Spina Bifida live in their communities instead of institutions. Waivers may cover services like personal care, respite care, and home modifications.
California Children's Services (CCS): CCS provides medical care and support for children with certain chronic conditions, including Spina Bifida. CCS covers diagnosis, treatment, and rehabilitation services.
In-Home Supportive Services (IHSS): IHSS provides in-home care for people with disabilities who need help with daily living activities. Eligibility is based on need and income.
Regional Centers: California's regional centers provide services and support for people with developmental disabilities. Spina Bifida may qualify for regional center services if it causes developmental delays.
Work Incentives: California has programs to help people with disabilities work, such as the Ticket to Work program and Work Incentives Planning and Assistance (WIPA) counselors.
Reporting Changes: It is important to report changes in income, resources, or living situation to avoid overpayments and ensure you receive the correct benefits.
Step 5: Apply for Medicaid Waivers
Step 6: Apply for California Children's Services
Step 7: Apply for In-Home Supportive Services
Step 8: Apply for Regional Center Services
Step 9: Apply for Work Incentives
Step 10: Report Changes
In-Home Supportive Services (IHSS): IHSS provides in-home care for people with disabilities who need help with daily living activities. Eligibility is based on need and income.
Regional Centers: California's regional centers provide services and support for people with developmental disabilities. Spina Bifida may qualify for regional center services if it causes developmental delays.
Work Incentives: California has programs to help people with disabilities work, such as the Ticket to Work program and Work Incentives Planning and Assistance (WIPA) counselors.
Reporting Changes: It is important to report changes in income, resources, or living situation to avoid overpayments and ensure you receive the correct benefits.
Overpayments: If you receive more benefits than you are entitled to, you may have to repay the overpayment. Overpayments can occur if you do not report changes in income, resources, or living situation.
How to Report Changes: Report changes to the relevant agency as soon as possible. You can report changes online, by phone, or in person.
Avoiding Overpayments: Keep records of all communications and documents. Report changes promptly. If you are unsure whether a change affects your benefits, contact the agency for guidance.
In 2025, California SDI and PFL benefits increase to 70% or 90% of wages, up from 60% or 70%. The maximum weekly benefit is $1,681. The payroll contribution rate is 1.2% of earnings, with no wage cap.
Medicaid waivers provide home and community-based services for people with disabilities. They can help people with Spina Bifida live in their communities instead of institutions. Waivers may cover services like personal care, respite care, and home modifications.
An ABLE account allows people with disabilities to save money without losing eligibility for SSI and Medicaid. In California, the ABLE account is called CalABLE. You can save up to $18,000 per year in 2025. The account can be used for disability-related expenses.
It is important to report changes in income, resources, or living situation to the relevant agency as soon as possible. You can report changes online, by phone, or in person. Keep records of all communications and documents.
California has programs to help people with disabilities work, such as the Ticket to Work program and Work Incentives Planning and Assistance (WIPA) counselors. These programs help people work without losing benefits.
