Q: My brother is 55 years-old and has an intellectual disability. He has disability-based Medical Assistance (MA) and has been receiving Supplemental Security Income (SSI) benefits since he was 18 years old. Now, he is receiving Survivor benefits through my mom’s Social Security account, which is well above the $1,012 monthly income limit for his MA. The county financial worker said he will have a spenddown that he has to meet with medical bills and expenses before his MA coverage begins. Do we have any options? MA is his only health insurance coverage.
A: Your brother may be eligible for something called a “Disabled Adult Child Disregard.” This applies to some adults who were receiving SSI based on blindness or disability prior to age 22. When a parent, who had been paying Social Security taxes out of their paycheck, passes away or retires, their adult children are entitled to Retirement, Survivors and Disability Insurance (RSDI) benefits. For your brother, this significantly increased his monthly Social Security benefit amount—putting him over the monthly MA income guideline.
First, it is helpful to contact the Social Security Administration and ask for documentation of your brother’s Disabled Adult Child benefit status and the date he started receiving SSI benefits based on his own disability. If it was before age 22, contact the county financial worker again. Offer to send in the Social Security documentation and ask her to review his case to see if he is eligible for the disregard. If the county approves it, your brother can receive the RSDI benefits and have access to Medical Assistance without the spenddown.
Please call The Arc at (952) 920-0855 if you have further questions or need help! Another great resource for the Disabled Adult Child Disregard is Disability Benefits 101.