At some point in time, recipients of disability benefits may require admission to a nursing home, hospital, or similar medical facility. Many wonder how this affects their disability benefits. In most situations, if a recipient of Supplemental Security Income (SSI) benefits enters a nursing home, hospital, or medical facility where Medicaid pays for more than half of the cost of care, SSI cash benefits are limited to $30 a month. The Social Security Administration (SSA) may lower the $30 benefit by any other income received by the SSI recipient.
Generally, if a child under age 18 enters a nursing home, hospital or other medical facility where Medicaid or private health insurance, alone or a combination thereof, pays for more than half of the cost of care, the child’s SSI benefit is limited to $30 a month (plus any supplementary Kentucky State payment). The Social Security Administration (SSA) may lower this $30 benefit by any other income received by the child.
Individuals age 18 or over living in a public medical facility where Medicaid is not paying for more than half of the cost of care, are not eligible for any SSI benefit. Similarly, if a child under age 18 lives in a public facility where neither Medicaid nor private health insurance, alone or in combination, is paying for more than half of the cost of care, the child is not eligible for any SSI benefit.
The State of Kentucky supplements the federal SSI payment. The amount of the state supplement depends on the recipient’s living situation. For both personal care facilities and family care homes, couples are treated as individuals. Thus, the supplement is $520 a month for personal care facilities and $172 a month for family care homes. With a caretaker at home, the supplement is $62 a month for individuals and $115 a month for couples.
A special rule applies if an individual is placed in a qualifying facility for 90 days or less. If the SSA is provided with certain information, it may continue to pay regular SSI benefits for up to three full months. A doctor must state in writing that an individual will be institutionalized in a medical facility for 90 consecutive days or less. The SSA also requires a statement that an individual’s circumstances necessitate the continuation of benefits to maintain a living arrangement while institutionalized. The SSA requires these statements as soon as possible after a facility is first entered. They must be submitted before the individual leaves the facility or by the 90th day of residence there, whichever is earlier.
The assistance of an experienced disability attorney may help you navigate the often lengthy and complicated process of applying for disability benefits. Retain the services of an experienced, knowledgeable, and qualified Social Security Disability attorney. We offer free consultations, so there is absolutely nothing to lose! Contact the Sullivan Law Office to get the help you need in the Louisville metro area. Call 888-587-0228 or visit us online.