Tuesday, December 5, 2023

Is Social Security Disability Considered Income For Medicaid

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Information Needed To Apply For Social Security Disability Benefits

Do I Have To Be Receiving Social Security Disability Benefits To Apply For Medicaid?

Processing claims for disability benefits can take anywhere from 3-5 months. Gathering required information prior to filing a claim may expedite the process. You will need the following information to apply online:

  • Social Security number
  • Basic spousal information
  • Basic information for any children under the age of 18 or those who became disabled before the age of 22
  • Military service, education or training
  • If you are self-employed, business type and total net income
  • If you are not self-employed, name of employer, start and end dates of employment, total earnings for the past two years
  • Direct deposit information
  • Medical information including conditions, doctors, hospitals, clinics at which youve received examinations, tests, treatments, etc.
  • Names, dosages and information of all medications
  • Employment history for the 15 years prior to becoming disabled

To apply over the phone or in person, you will need the majority of the above as well as:

  • Medical records already in your possession
  • Medical and Job Worksheet Adult, which can be found here.

Is Social Security Taxed After Age 70

Heres why: Every dollar you earn over the 85% threshold amount will result in 85 cents of your benefits being taxed, plus youll have to pay tax on the extra income. After age 70, there is no longer any increase, so you should claim your benefits then even if they will be partly subject to income tax.

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Problems With Access To Medicaid

Because States have considerable flexibility in setting their Medicaid eligibility policies, where a low-income disabled person lives makes a big difference. Disabled persons in identical circumstances are not treated the same from State to State. As a result, many of the barriers to Medicaid involve interstate differences which have resulted from State policy options. Although there are understandable reasons for the flexibility States have been given to establish their own criteria for Medicaid eligibility, this flexibility has resulted in inequities with regard to access for the low-income disabled. Access problems also result from inconsistencies in the patchwork of Federal rules that govern eligibility policies. Finally, other barriers to eligibility are a result of implementation issues, not policies per se.

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What Is The Difference Between Ssi And Ssdi

SSI eligibility is determined based on age, disability and available resources, while SSDI is based on a persons disability and work credits.

For most people, medical requirements that will allow you to receive disability payments are the same for both, and disability is determined using the same process. Both SSI and SSDI are managed by the Social Security Administration as well.


Location and monthly income

Record of earnings

The most notable difference between SSI and SSDI is that SSDI is only available to people who have accumulated enough work credits, while SSI is available to low-income individuals who have not accumulated enough work credits or who have never worked. In addition, SSDI is based on your work history, but SSI is strictly based on a financial situation of considerable need.

Additionally, SSI benefits begin on the first of the month that a social security disability application is submitted and approved, but for SSDI there is a five-month waiting period. People who qualify for SSI can also receive Medicaid benefits. After receiving SSDI benefits for two years, a disabled person will be eligible for Medicare benefits. The amount of SSI benefits depend on where a person lives and what their monthly income is, while SSDI benefit amounts are dependent on a persons earnings record.

When Doesmedicare Or Medicaid Start

Medicaids Role in Financing Behavioral Health Services ...

SSDI recipients aren’t eligible to receive Medicare benefitsuntil two years after their date of entitlement to SSDI . Because it oftentakes a year or two to be approved for disability benefits, however, SSDIrecipients often become eligible for Medicare soon after they get their awardletter from Social Security.

In the states where Medicaid eligibility is automatic for SSIrecipients, there is no waiting period for SSI recipients to receive Medicaid.In other states, you need to apply separately for Medicaid, but there is nowaiting period.

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What Is The Highest Income To Qualify For Medicaid

Each state sets its own eligibility requirements for Medicaid, including income limits.

Medicaid uses the Federal Poverty Level as a benchmark to determine ones eligibility. In most states that grant Medicaid to low-income adults, individuals are eligible for Medicaid if they have an income that is at or below 150% of the FPL. The state in which you live and the type of Medicaid you are applying for may dictate a different income amount.

How Does The United States Compare With Other Countries

According to a recent analysis by the Organisation for Economic Co-operation and Development, or OECD, the United States has the least generous disability-benefit system of all OECD member countries except Korea. The OECD describes the U.S. disability-benefit system, along with those of Korea, Japan, and Canada, as having the most stringent eligibility criteria for a full disability benefit, including the most rigid reference to all jobs available in the labor market and the shortest sickness benefit payment duration. In addition, the United States spends less as a share of its economy on incapacity-related benefits than other nations. In 2009 public expenditures on incapacity-related benefits comprised just 1.5 percent of U.S. gross domestic product, or GDP, compared to an average of 2.4 percent for all OECD nations.

Proponents of cutting disability benefits in the United States sometimes point to particular elements of disability program reforms in Europeparticularly in Germany, the Netherlands, and the United Kingdomas potential models for changes to the Social Security disability programs. In general, however, such proposals fail to take into account that these nations have much more generous disability systems, less rigorous disability standards, higher levels of social expendituresnot just on incapacity benefits but on social assistance generallyand more regulated labor markets than the United States.

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Who Will Supplemental Security Income Help

Currently, the only recipients in the Special Income Level group whose eligibility is not impacted are those receiving Supplemental Security Income . Non-SSI recipients would fall into the Special Income Level group even if the income is less than $750 and could be impacted by the budget cuts. Waiver recipients will lose waiver benefits unless they are eligible and receive SSI.

We recommend you apply for SSI if you have not already done so in order to protect your current Medicaid eligibility. It can sometimes take around six months for an SSI eligibility determination to be made by the federal government.

Medicaid: What Do I Count As Income

SSI and Medicaid – 1619(b)

Marketplaces, Medicaid, and CHIP all use MAGI to determine a households income for eligibility. MAGI stands for Modified Adjusted Gross Income. The best way to figure it out is to work through the numbers backward.

Start with your gross income, which is your total taxable income. If you have multiple income streams, you add them all together to get your total income. Taxable income may include wages, salaries, bonuses, alimony, self-employment income, pensions, punitive damages, IRA distributions, jury duty fees, unemployment compensation, rents, royalties, severance pay, gambling winnings, interest, tips, and estate or trust income.

You may also be receiving income that is not considered taxable. You do not have to include this income when applying for Medicaid. Types of non-taxable include may include child support, gifts, veterans benefits, insurance proceeds, beneficiary payments, AFDC payments, injury payments, relocation pay, TANF payments, workers compensation, federal income tax refunds, and SSI payments.

Once you know your gross income, you can subtract IRS-approved deductions to get your adjusted gross income . For those that are self-employed, these deductions include any business related expenses. They also include alimony payments, IRA contributions, tuition and fees, student loan interest, and work-related moving expenses.

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What Is The Long Term Care Special Income Level Program

The Long Term Care Special Income Level program covers individuals who are aged, blind or disabled and who qualify for institutional level of care because of their medical needs with monthly income over $750. These members are either in facilities such as nursing facilities or group homes or may be receiving home and community-based waiver services .

Does Medicaid Come Out Of Social Security

Your Medicaid benefits are not deducted from your Social Security check. Some things that may be deducted from your Social Security benefits include:

  • Enforcement of a child, spousal or family support obligations
  • Overpayment of benefits

Certain individuals may be required to pay a small premium for Medicaid, but it will not be deducted from your Social Security check directly.

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Medicaid If You Have A Disability Or A Child With A Disability

Supplemental Security Income disability benefits are for adults or children who have a disability and meet income, resource and living arrangement requirements. Although the standards for determining if you have a disability are the same as for Social Security Disability Income , you do not have to have paid Social Security taxes to qualify for SSI. Once you qualify for SSI, you are also eligible for Medicaid.

Wisconsin Supplemental Security Income: Additional information from the Wisconsin Department of Health Services, including information on qualifying for Supplemental Security Income.

The Medicaid Purchase Planoffers people with disabilities who are working or interested in working the opportunity to buy health care coverage through the Wisconsin Medicaid Program. Depending on an individual’s income, a premium payment may be required for this health care coverage. This information is also available in other languages.

The Katie Beckett Program allows certain children with long-term disabilities or complex medical needs, living at home with their families, to obtain a Wisconsin Medicaid card. Children who are not eligible for other Medicaid programs because the income or assets of their parents are too high may be eligible for Medicaid through the Katie Beckett Program.

Additional information about Medicaid is available.

Coverage Of Disabled Persons


There has been substantial growth in the number of disabled persons under both the Medicare and Medicaid programs. Enrollment of the disabled for both programs from 1975 through 1988 are shown in and . Disabled Medicare enrollees grew significantly from 1975 to 1980, increasing from 2.2 million enrollees to almost 3.0 million, an increase of 36 percent . From 1980 to 1988, the number of disabled Medicare enrollees remained relatively stable. The disabled population in the Medicaid program has exhibited a somewhat different pattern. The number of recipients grew at a moderate pace during the period 1975-80, increasing 19 percent from 2.3 million to 2.8 million. As under Medicare, the number of disabled Medicaid recipients remained stable during the early eighties, but from 1984 to 1988, the number of recipients grew from 2.8 million to 3.3 million, an increase of 20 percent.

Number of disabled Medicare enrollees under age 65 for 1975-88 and disabled Medicaid recipients for fiscal years 1975-88

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Disability Benefits For Veterans

You may be eligible for disability benefits if you’re on disability from your service in the Canadian Armed Forces or Merchant Navy.

You may get social assistance payments from:

  • your province or territory
  • your First Nation

These payments will depend on your household income, savings and investments.

You may also be eligible for health-related benefits from your province or territory. These benefits may include benefits that help cover the cost of:

  • medications
  • medical aids or devices

Aged Blind & Disabled Medically Needy Medi

If you cannot qualify for free Medi-Cal or Medi-Cal’s Working Disabled Program , you may be able to get Medi-Cal through the Aged, Blind, & Disabled – Medically Needy program. However, you would to pay a share of cost. A share of cost is a certain amount of money you must spend on medical care each month before Medi-Cal begins to pay for services.

If you are single, you can figure out your share of cost by following the first step for calculating A& D FPL eligibility. After Step 1, take your countable income and subtract the MNL for your family size including yourself and also subtract any health, dental, or vision insurance premiums you pay each month. The resulting figure is your share of cost each month. If you get a number that is 0 or less, then you have no share of cost. You only have to pay a share of cost in months when you have medical expenses.

There are good factsheets translated into a several languages about how your share of cost works.

You live alone and have $1,581 per month in countable income and have no other insurance. Your countable income is too high for free Medi-Cal and you don’t work, so you can’t get Medi-Cal’s Working Disabled Program. You qualify for ABD-MN Medi-Cal.

Your share of cost is $1,581 – $600 = $981. You will have to pay the first $981 in medical expenses during the month before Medi-Cal will start covering you.

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Disability Application Starter Kit

To assist you in creating your application, Social Security has developed a Disability Starter Kit that provides information about the documents and information that you will be requested to provide. Because an application can be complicated and lengthy, this is a good place to start and to keep you organized. The kit also explains how Social Securitys disability programs work and what decision-making processes are used to determine your eligibility.

Social Security offers two kits, one for adults and another for children. The adult Disability Starter Kit can be found here. And the child Disability Starter Kit can be found here.

Alternatives For Improving Access

Government Assistance Programs – Medicare, Medicaid, and Social Security Income

To improve the access of low-income disabled persons to Medicaid and Medicare, a series of options for restructuring program eligibility requirements are presented. Low-income disabled workers without access to health care are the focus of many of the proposed reforms. In the current system of public health care financing, arguably the disabled person who is the worst off with regard to health care coverage is the SSDI beneficiary who is ineligible for Medicaid during the 24-month waiting period for Medicare.

Denying or restricting access to health care financing for disabled workers, while providing it at no cost to the disabled who have not worked, seems to be the greatest inequity in current eligibility provisions for Medicaid and Medicare. Work is one of the major values in our income maintenance and health care financing systems. Accordingly, the reforms have as their objective opening Medicaid and Medicare to all the low-income disabled and restoring some reward for having worked.

The proposed changes were not designed to fit together into one package. Sometimes more than one option is presented to remedy a particular access problem. In addition, Congress and the Administration could enact some of the reform options without electing others.

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Social Security Disability Work Incentives

Special rules make it possible for those receiving SSDI benefits to go back to work while continuing to be paid the monthly benefits. This is for those workers whose disability is not life threatening and have some capacity to work.

Three incentives are offered by SSDI for people attempting to go back to work: trial work period, extended period of eligibility, and expedited reinstatement.

Why Is The State Notifying People They May Lose Medicaid Eligibility

The budget does not have enough funding for the critical needs of the state. In order to wind down programs that may be eliminated, a lengthy regulatory process must take place. As this process is underway, it is important to keep people as informed as possible. As of today, people will continue to receive their benefits.

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Appealing Denied Social Security Disability Application

Its common for applicants to be denied. In fact, only about 1 in 3 applicants are initially approved for SSDI benefits. The two main reasons for denial are usually a lack of work credits, or that applicants do not meet the criteria for disability.

If you have been turned down, you do have the right to go through a Social Security Disability appeal process. Either you or your designated representative can file a Request for Reconsideration. Your initial appeal will then be turned over to Disability Determination Services, who will thoroughly review your file.

If you are denied again, you can proceed to the next level of appeal which is to appear in front of an Administrative Law Judge. An Administrative Law Judge will conduct a hearing in which all of your medical records and testimony will be heard before the judge renders a decision in the form of a written notice.

If you are still denied benefits, then you have a final appeal step you can take: filing a lawsuit in U.S. district court. You will need an attorney for this step if you havent already retained one. This can be an expensive and time consuming option, and as a result, less than 1% of disability claimants take their cases to this level.

Ssi And Spousal Income


Supplemental Security Income is a needs-based disability program that provides financial assistance to low-income disabled people. These individuals did not pay into the Social Security program, so their disability benefits arent based on their individual work history.

Instead, SSI recipients must meet the financial and resource limits to qualify for benefits. One aspect of the financial and resource limits is what the SSA calls deemed income. If a disabled person is married and living with their spouse, the SSA assumes a portion of their spouses income is deemed income. If the nondisabled spouse makes a good or even fair income, the disabled spouse will likely lose his or her SSI benefits.

We recommend claimants consult a professional disability lawyer if they have questions about deemed income since the laws are complex. But in general, the spouses combined countable income cannot exceed $2,467 or $1,211 depending on whether than income is classified as earned or unearned.

If both spouses are disabled, they must both meet the financial eligibility requirements for a couple. Their income is counted together, without using the deeming formula.

In closing, spousal income is not a significant factor for SSDI claimants but may pose a problem for SSI claimants. If you have questions about either program and whether your spouses income will disqualify you, wed be happy to offer you a free consultation on your claim.

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