r/Medicaid • u/sportinwood504 • 1d ago
Aging Out of SSI Benefits
What happens with Medicaid benefits when someone who's been receiving SSI ages out at 62 and starts receiving retirement benefits? In this case the monthly payment will only be $50/month more ($994 vs $1044) keeping income far below the annual FPL. Also wondering what happens to disability status when this changeover occurs? Asking for a resident of Louisiana.
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u/wolfofone 22h ago
Like Medicaid, SSI is a needs based program of last resort. In order to be eligible for SSI you must take any earned benefits you are eligible for. If you decline to take them you will lose SSI. If the person has never worked or not worked enough to get SSDI it is unlikely they will get enough early retirement to disqualify them from medicaid. If they are in a state that expandeed medicaid they should qualify for MAGI medicaid even if they no longer qualify for AABD medicaid from getting SSI. If they are in a non expansion state they might qualify for a medicaid spenddown if they have disability related medical expenses where those expenses could be used to reduce income after which they would get medicaid coverage the rest of the month. Once they hit age 65 they can get Medicare and may qualify for MSP and Extra Help programs.
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u/OleLadyThinker 8h ago
There is all kinds of other income which they may become eligible for at specific ages. Like a divorced spouse benefit or a divorced widows benefit - if they are disabled, they can get it as young as 50 or if not disabled at age 60. Same thing for Survivors widows benefit or widowers - 50 if disabled; 60 other wise -
All of these things are as a result of filing application for them and then SSA checking all the paperwork of marriage / divorce/ or death.
I kind of wonder how many SSI beneficiaries know or find out about their other benefits - does the SSA let them know of any possible ones?
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u/No-Donut-8692 21h ago
So at 62, the beneficiary would be under ACA expansion rules. Income limit is about 1800 for household of one. Pretty sure the income would be too high for ABD, but would need more details (and the time to actually look it up-sorry!).
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u/StraightNight4379 13h ago
What about someone in a nursing home. I will be 64 next month and retired two years ago
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u/Moiras_Roses_Garden4 1d ago
When someone stops receiving SSI and starts receiving SSA they would typically also transition to Medicare as coverage. So you'd enroll in part A and B and then choose a part D prescription plan. B and D have a premium but states have programs to help pay those that require a separate application.
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u/Ok-Lake3522 22h ago
Must be 65 for Medicare. A person is eligible for Social Security at age 62, but cannot get on Medicare until age 65. I know from personal experience…I am 63 and collecting SS but am uninsured because I’m not old enough for Medicare but even Marketplace ACA insurance is too expensive. I work, so I’m not eligible for Medicaid.
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u/sportinwood504 18h ago
Have you looked into the Medicaid Spend Down (MSP) program?
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18h ago
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u/Blossom73 17h ago
As I understand it, Medicaid Spend Down is only for those over 65 who want to become income-eligible for Medicaid for the purposes of Long Term Care
No. A Medicaid spenddown is a program where someone who is over income for Medicaid can "spenddown" each month by submitting proof of medical expenses equal to or greater than their excess income each month. It's sometimes called "medically needy".
Not all states have a spenddown program though.
As far as taxes go, most Social Security recipients don't owe taxes on their benefits.
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17h ago
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u/Blossom73 16h ago
I'm not sure what advice you're asking for then.
I understand what you're saying, but this sub isn't the place for political debates about the American healthcare system.
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16h ago
[removed] — view removed comment
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u/Blossom73 16h ago
I wasn't at all rude to you. Knock it off or you'll be permanently banned from this sub.
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u/Moiras_Roses_Garden4 13h ago
People who are determined to be disabled for 2 years become Medicare eligible.
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u/Otherwise-Concern970 20h ago
Since you will have received SSI and SSA for same month you will become a Pickle so your future SSA COLA's will be excluded from the income calculation. If you are only about $50 over then you will be SSI Related Medicaid eligible within a couple years.
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u/sportinwood504 18h ago
🤔 I'm not even remotely understanding what you're trying to say here. First off what are you referring to in regard to receiving "SSA" (which stands for Social Security Administration)? I'm assuming you're improperly using that acronym instead of the proper one for retirement benefits, OASI (Old-Age and Survivors Insurance). Secondly where are you coming up with anyone receiving SSI and SSA/(OASI) benefits in the same month? The post mentions retirement benefits/OASI replacing SSI due to the OASI benefit exceeding the SSI benefit by $50. In addition COLA plays absolutely no part in this scenario and, therefore, the Pickle Amendment is extraneous here. Finally the part about being "SSI Related Medicaid eligible within a couple years" makes no sense whatsoever as the recipient (anyone) receiving SSI has automatically been receiving Medicaid due to their disability. The original question was how switching over to OASI was going to affect Medicaid eligibility. Your reply did nothing but muddy the waters unless i'm missing something.
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u/Otherwise-Concern970 17h ago
The Pickle rule is not extraneous. You will automatically have overlapping SSI and SSA benefits since the SSA benefit pays the following month. Therefore Pickle will apply. I just said SSA since the Pickle rule doesn't care which form of the various SSA benefits overlaps. You will lose SSI Medicaid, if you are in an expanded state you will be ACA eligible until Medicare starts. Then you have to be considered for SSI Related Medicaid in which the Pickle will very much affect future eligibility.
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u/sportinwood504 11h ago
I just spent an hour typing something out in response to this** *and it disappeared. First I* wanna** ***say* thank you for making me aware of the Pickle amendment. I had no idea it even existed. Now I know enough about it to be completely confused. In reading the information on the SSA website** ***it seems like it's mostly geared towards individuals who lose their SSI because of* COLA increases. But in digging a little further it also seems to cover individuals in the exact situation I was posting about, with discontinued SSI yet still being considered disabled by Medicaid** *in order to retain that benefit.* ***I just can't find any official, easy to understand,* source stating this fact. Either way it's good to know it exists. At this point** ***I am going to recommend the Medicaid* Expansion route before trying to pull out the Pickle** ***but it's good to know that it's* there as it's written into law. Again thanks for bringing it to my attention.
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u/Otherwise-Concern970 9h ago
Yes the Pickle talks a lot about COLA but the requirements to qualify is only getting SSA and SSI at same time. Not close due to COLA. If not eligible ACA then State have to get State Disabled decision to keep looking at SSI Related Medicaid. It's a confusing area of Medicaid.
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u/Blossom73 1d ago edited 21h ago
Full retirement age for anyone born after 1960 is 67. 62-66 is early retirement for people born after 1960.
If the person has sufficient work credits for Social Security retirement benefits they'll be automatically switched to retirement benefits when they're eligible for them.
If they do not have sufficient work credits for Social Security retirement benefits they'll remain on SSI until death. Assuming they don't become eligible for spousal or survivor's due to marriage.
SSI recipients are categorically eligible for Medicaid. Receiving even $1 of SSI qualifies someone for Medicaid.