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Public BenefitsOverview of Benefit ProgramsSpending Guide For TrusteesConfusing Nomenclature Analyzing Benefits
SSISample Letter

Overview of Benefit Programs

 

A trustee of a Special Needs Trust making spending decisions needs to consider whether a benefit program is “means tested”. A beneficiary who is receives Social Security and Medicare, for example, can receive any amount of money from any source with no interference with their benefits. Means tested means that the income or savings a person has will affect whether s/he is eligible for the program. If a program is not means tested, spending by the trust does not affect eligibility

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Money Benefits

Means Tested Available to people with disabilities who are also economically indigent.

SSI Supplemental Security Income

SSI is a federal program that provides monthly checks to people whose financial resources are less than $2,000 and whose income in less than about $650 per month

NOTE: The most restrictive rules limiting in-kind support and maintenance apply only to SSI recipients,  not to people on Medicaid or other benefits.

NOT means tested.

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Available to people who have paid into the Social Security system and their dependents.

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Eligibility based on age and disability status, but not financial status

Social Security Retirement Available to all who have paid into the program through payroll deductions and then retired.

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Social Security Disability ( SSD or SSDI)
Available to all who have paid into the program through payroll deductions BUT become unable to work due to an injury or medical condition, whether job related or not.

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Social Security Survivors Benefits Available to minor children of people who have paid into the program through payroll deductions and died.

Disabled Adult Child)(aka DAC, SSDI, SSD)
Available to the adult sons and daughters of people who have paid into Social Security and either retired or died PROVIDED the son or daughter became disabled prior to age 22
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Benefit amounts vary based on worker contributions.

Mixture Combination of needs based and social insurance benefits.

SSDI plus SSI

If the SSDI benefit is less than about $650 per month, the recipient is almost always also entitled to SSIz as well.

The recipient receives two checks or direct deposits.

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Medical Benefits

Means Tested Available to people with disabilities who are also economically indigent.

Medicaid

Medicaid provides comprehensive medical and pharmacy services to eligible individuals.

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A person who meets the income and resource limitations for SSI is automatically eligible for Medicaid.

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Medicaid eligibility is also available for many people with income from SSDI or other sources that exceeds the SSI limits. People in “Medicaid eligible” facilities and programs may have significant income but remain eligible for Medicaid based on costs of care and treatment. The high cost of such care makes the person “medically needy”.

NOT means tested.

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Available to people who have paid into the Social Security system and their dependents.

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Eligibility based on age and disability status, but not financial status

Medicare

All beneficiaries of  Social Security receive Medicare. There is only one Medicare, the benefits are the same for all Medicare recipients everywhere.

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If the income is from Social Security Administration and is not SSI, the person is eligible for Medicare

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Not all beneficiaries are immediately eligible, however. Adults who become eligible on a parents  claim will not be eligible for Medicare for the first 2 years.

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All Medicare recipients should have a supplemental policy, unless they are also receive Medicaid, see below.

Mixture Combination of needs based and social insurance benefits.

Medicare and Medicaid

People are eligible for both Medicare and Medicaid when

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1. The person receives both SSI and SSDI, as described above.

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2. The person receives SSDI only, but has sizeable medical expenses that are not covered by Medicare. This is usually the case when an SSDI recipient is in a nursing home or similar facility. Medicare does not cover these costs for most people.

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Other Means Tested Benefits

GAU

General Assistance Unemployed

Gau is a means tested program of Washington State,  providing $339 monthly income (as of 2004) to individuals  who have no other source of income but who meet the eligibility requirements for SSI or SSDI. Application procedures  for federal benefits commonly take over a year to complete, chiefly owing to arbitrary behavior by the federal  government. GAU eligible people are almost always eligible for and receive Medicaid, another state administered program.

Many GAU recipients are receiving the benefit as a stop gap pending finalizing eligibility for SSI. When SSI eligibility is approved, the applicant typically receives an SSI  “back-payment” for each month of eligibility from the application date forward. The amount of the SSI “back payment” is reduced by the amount of GAU the person has received in the interim.

Other

Most SSI recipients and many low income recipients of SSDI are eligible for a wide variety of other needs based programs. Eligibility is often not as strict as for SSI, but is still highly restrictive. These programs include public housing g (Section 8), food stamps, bus passes.

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