Social Security will continue to pay Child's insurance benefits (these are payments on a parent's record due to the retirement, death or disability of a parent) to a child age 18 or over who was disabled before age 22, whether or not they received such payments as a minor child. The "adult child" can apply at any time, but must be able to prove the disability started before age 22. We refer to an individual who receives "Child's insurance benefits" when they reach 18 years old as a Disabled Adult Child or DAC. A person who was receiving SSI may lose their SSI when they become eligible for the child's benefit, or when they get an increase in those benefits. It is these people who may qualify for protected medical assistance status.
The following rules must be satisfied:
- Individual is age 18 or over AND
- Individual is currently entitled to and receives Title II Disabled Adult Child's benefit on a parent's record due to the retirement, death or disability of a parent AND
- Individual has a disability or blindness which began before age 22, AND
- Individual has received SSI and then lost the SSI payment after July 1, 1987 due to receipt or increases of the Title II Disabled Adult child's benefit AND
- Individual satisfies the Resource Test for DAC (See Resource Rules in Section 4 of this chapter) AND
- Individual satisfies the Income Test for DAC (See Resource Rules in Section 5 of this chapter)
Income Requirements
If the individual only receives Title II Disabled Adult Child payment (no other income type), then there is no need to do an income test, otherwise an income test must carried out.
DAC Financial Unit
The financial unit will consist of one of the following:
- Individual With No Spouse
- The disabled adult child AND
- If the disabled adult child is an alien, the income of the alien's sponsor and the sponsor's spouse if the spouse lives with the sponsor is included.
- SSI Recipients are not included.
- Eligible Couple
- The disabled adult child AND
- If the disabled adult child is an alien, the income of the alien's sponsor and the sponsor's spouse if the spouse lives with the sponsor is included AND
- The spouse who is living in the home AND
- The spouse is also potentially eligible for Medical Assistance under the Disabled Adult Child, Pickle or Disabled Widow(er) category AND
- If the spouse is an alien, the income of the alien's sponsor and the sponsor's spouse if the spouse lives with the sponsor is included.
- SSI Recipients are not included.
- Eligible Individual With Ineligible Spouse
- The disabled adult child AND
- If the disabled adult child is an alien, the income of the alien's sponsor and the sponsor's spouse if the spouse lives with the sponsor is included AND
- The spouse who is living in the home AND
- The spouse is not eligible for Medical Assistance under the Disabled Adult Child, Pickle or Disabled Widow(er) categories AND
- The spouse is receiving Title II benefits as a widow/widower, ex-wife/ex-husband, parent, disability payments under their own work history.
- SSI Recipients are not included.
Resource Household Size for Disabled Adult Children
The household size consists of the same individuals as listed in the financial unit above with the following exceptions:
- Do not include the alien's sponsor and the sponsor's in-home spouse in the household size OR
- Do not include a parent(s) living in the home in the household size OR
- Do not include SSI recipients in the household size
Income Household Size for Disabled Adult Children
The household size consists of the same individuals as listed in the financial unit above with the following exceptions:
- Do not include the alien's sponsor and the sponsor's in-home spouse in the household size OR
- Do not include SSI recipients OR
- Do not include the ineligible spouse in the household size when there is no deemable income