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

Analyzing Benefits: Is it SSI or SSDI or Social Security or Medicare or Medicaid or what?

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This page is intended to assist in identifying what benefits a client is likely to be receiving, in order to avoid causing eligibility problems; or should be receiving in order to assist the client to maximize benefits.

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It is often quite important to know whether a person is on SSI or some other benefit. The restrictions on how the trustee can behave are different for clients who need to maintain SSI eligibility. A client who is eligible for benefits that are not in place can be assisted to make application.

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Refer to the neighboring pages for descriptions of the terms and programs referenced below. Most of the time the programs described below are involved, but there are many other income and medical programs, government and private.

The first rule is: Trust No One. The only way to know for certain the provenance of benefits is with written records. Seasoned professionals routinely say Medicare when it is Medicaid, and vice versa; less seasoned people don’t realize there is a difference. Ditto Social Security and SSI.

Income

 

Work History If the person or his/her spouse worked for a period of time and retired or became disabled, good chance that person receives Social Security, not SSI. The older the person, the more likely this is the case.

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Assets Someone with over $2,000 in money or investments is not eligible for SSI.

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Amount of Income The SSI benefit amount for 2019 is $771 per month for individuals and $1,157 for couples. If the amount received is more than this, the client is probably not on SSI. If there are two checks for exactly $20 more than the benefit amount, the client probably receives a small amount from some other program, and SSI pays enough to get income up to the SSI amount plus $20.

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What it Says on the Bank Statement. 

SI

Means SSI

SOC SEC

Means  either Social Security Retirement OR social Security Disability.

SSDI

 Means Social Security Disability

SSD

Means Social Security Disability

DAC

Means Disabled Adult Child means Social Security Disability on the parent’s work record

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Banking Activity

Number of deposits per month

Amount of deposits

Except

Probably SSI

1 deposit

exactly the SSI amount.

Some States add in to the SSI amount:
California, Hawaii, Massachusetts ,Nevada, New Jersey, New York, Pennsylvania, Rhode Island, Vermont, Washington D.C.

NOT SSI

1 deposit

Over the SSI amount

Probably SSI and something else

2 deposit

Exactly the SSI amount plus $20

See above   (Social Security amounts vary from $100 to $3,60/ month.)

Investigation
needed

If individual has zero income the person may be eligible for SSI, SSA, SSD, etc; but been cut off for failure to comply with reporting requirements, or in extreme cases have demanded to be taken off the program.

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If there is income less than the SSI amount from an undetermined source, it may be SSI if

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● The person was somehow overpaid by SSI and checks are reduced to make it up (An SNT can pay the overpayment amount to SSI); or

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● SSI has determined that the person receives in-kind food or shelter (structuring SNT spending can eliminate the in-kind problem

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Medical Benefits

Social Security

SSI

Both SSI and Social Security

Medicare

A person who receives money from the Social Security Administration EXCEPT SSI is almost always eligible for Medicare

Ordinarily a person eligible for SSI but not Social Security  is not eligible for Medicare

Someone whose Social Security check is below the SSI amount can also qualify for SSI, and will have both Medicare and Medicaid

Medicaid

A person who receives an adequate* Social Security payment, and is living independently, and has assets (not counting the house) in excess of $2,000 is ordinarily not receiving Medicaid.

 A person receiving SSI is virtually automatically eligible for Medicaid

Both Medicare and Medicaid

Medicare does not cover custodial or care expenses for  people who require long term residential care, such as nursing homes, adult family homes, retirement homes or COPES.

A very common scenario is that a person who requires long term care and has resources in excess or $2000 is not eligible for Medicaid, and pays privately for long term care.

When they have “spent down” their resources below that $2,000 number, they become eligible for Medicaid which does pay for long term care.

Most often, the person never requires SSI, because they do receive Social Security is an adequate amount.they become eligible for Medicaid, which then does cover long term care expenses

* “Adequate” means in excess of the SSI amount, not “enough”

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