Clients often come to my office seeking a solution to the following problem: the client has lost Supplemental Security Income (SSI) and Medicaid coverage due to the receipt of Social Security benefits on a parent’s record based upon the retirement, death or disability of the parent. The client asks if it’s possible to continue receiving Medicaid even though the SSI income limit is now exceeded due to the beneficiary’s receipt of Social Security benefits on the parent’s record. The simple answer is “Maybe.” 

To preserve Medicaid coverage for beneficiaries who lose SSI payments, Congress enacted special Medicaid continuation provisions. These provisions require the State Medicaid agencies to consider certain former SSI beneficiaries as SSI beneficiaries for Medicaid purposes, as long as they would otherwise be eligible for SSI payments. However, if he/she receives income from another source or exceeds the SSI resource limits, the beneficiary may become ineligible for Medicaid coverage 

Section 1634(c) of the Social Security Act requires the States to consider childhood disability beneficiaries who receive Social Security benefits on a parent’s record due to the parent’s retirement, death or disability (also known as disabled adult children, or DACs) and, as a result, lose SSI eligibility as if they were still SSI recipients for Medicaid purposes. To continue Medicaid benefits, a DAC beneficiary must meet the following criteria: 

1. Must be at least 18 years of age;
2. Has blindness or a disability which began before the age of 22;
3. Has been receiving Supplemental Security Income (SSI) based on blindness or disability; and,
4. Has lost Supplemental Security Income (SSI) due to the receipt of Social Security benefits on a parent’s record due to the parent’s retirement, death or disability.

 In order to continue receiving Medicaid from the State after losing SSI eligibility, the DAC beneficiary should request a Benefit Award letter from the Social Security Administration verifying the receipt of Social Security benefits as a Disabled Adult Child who received SSI in the past. This letter should be taken to the County Welfare Board and submitted along with a completed Medicaid application and all required documentation.

A notice from the State of New Jersey on continuing Medicaid coverage for DAC beneficiaries is attached here – DAC flyer 1634 Updated 3-14