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Legislation: Finances

Disabled Adult Child and Title 19 Medical Assistance

November 30, 2001

Under a little-publicized law, a Disabled Adult Child (DAC) who loses Supplementary Security Income (SSI) continues to be eligible for Medicaid (MA) if his/her assets are under $2,000 and if his/her SSI benefits were lost solely because of an increase in Social Security benefits.

According to law, a Disabled Adult Child shall be considered for Medicaid purposes as being on SSI - and all Social Security payments which caused him/her to lose SSI eligibility are to be disregarded.

However, this is NOT automatically occurring.

Disabled Adult Children are incorrectly losing Medicaid coverage or receiving the wrong type of Medicaid coverage.

As a result, a Disabled Adult Child can face an impossible situation which includes: an administration and staff unfamiliar with the DAC law; multiple levels of government; multiple agencies within each level; private for-profit corporations; lengthy, confusing and endless notices; multiple hearings; and great difficulty in obtaining needed information.

Medicaid is a federal and state program with the Federal Government paying 50% to 80% of the cost (percentage varies between states).

Congress needs to ensure that this law is properly implemented.

A Disabled Adult Child (DAC) is one who is: At least 18 years old. Classified by the Social Security Administration (SSA) as disabled before age 22. Receives an Old Age Survivors Disability Insurance (OASDI) payment that is based on the earnings of a parent, who is disabled, retired or deceased. Was receiving SSI, but lost SSI eligibility because the OASDI (DAC) payment exceeded the SSI income limits.

An increase in SSA payments can occur for a DAC receiving Social Security benefits under the Family Maximum Benefit (FMB). For example, the SSA benefits of a family comprised of a retired worker, spouse and disabled children will be pro-rated, with the spouse and disabled children each receiving less than the standard benefit.

When a spouse or sibling dies, the individual benefits are to be recalculated, resulting in increased payments for the remaining family members. This increased payment can push the income of a DAC over the SSI limit, resulting in a loss of SSI benefits. Since Medicaid coverage is tied to SSI, Medicaid coverage could be lost also if DAC are not aware of the DAC law.

Although, according to law, increased payment in Social Security benefits for DAC shall be disregarded, and for Medicaid purposes, the DAC shall be considered as still receiving SSI.


You can be incorrectly pulled into a web of programs from which it is nearly impossible to extricate oneself.

You may well have to:

The list goes on and on - there is so much more! But mostly, it is the time stolen from the lives of those who cannot afford additional stress - stress that frequently exacerbates a disability. Time loss compounds the problems of individuals with disabilities and their families who, despite their additional time needs, must struggle to survive in a world with the same allotment of time as those without disabilities. Particularly, for parents in their 70s and 80s who have provided care for 50 or more years and are trying to find a humane solution for the DAC's future, time stolen seems criminal.

There are those who would have you believe that failures to properly administer the DAC law are isolated incidents. Not true! That is, in effect, saying that parents and siblings of disabled adult children never die.

I suggest the following recommendations:

Since the Federal Government, through the Social Security office already handles Medicaid coverage to SSI recipients, since the DAC law applies only to those individuals who have lost their SSI benefits due to increases in Social Security benefits, and since Medicaid coverage for DAC is a federal mandate, IT WOULD SEEM LOGICAL AND CERTAINLY LESS COSTLY TO SIMPLY HAVE THE FEDERAL GOVERNMENT CONTINUE TO HANDLE MEDICAID COVERAGE FOR DISABLED ADULT CHILDREN.

It could save the taxpayers millions, and it would meet the SSA requirements of simplicity and the best interests of applicants or recipients.

- Signed "An Aging Caregiver of Disabled Adult Children"

For more on the topic of Legislation:

Legislation and the Law

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[Updated November 30, 2001]
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