From Colleen Horton, Program Officer, Hogg Foundation for Mental Health, The University of Texas at Austin, Rosemary Alexander, TxP2P Staff, and Debbie Luzzo, TxP2P Parent and Realtor.
I have received a number of calls over the past year from families who have been told that their adult child is no longer eligible for Medicaid when they go from receiving SSI to SSDI. SSI is the Supplemental Security Income for folks with disabilities with low income. Many individuals with disabilities access Medicaid through their SSI eligibility. As parents begin to retire, their "adult child with a disability" often becomes eligible for Social Security Disability Income (SSDI) which typically has a higher monthly stipend than SSI. When they lose SSI (can’t receive both SSI and SSDI) they are sometimes told that their family member is no longer eligible for Medicaid because their income is now too high. The fear of losing Medicaid eligibility can cause a family significant stress as there is a two-year wait to receive Medicare services (health coverage available through SSDI).
This is not true. There is a provision in federal law referred to as the "Pickle Amendment" – named after our own Congressman Jake Pickle. This amendment states that if an individual’s monthly income is over the SSI limit simply because they went from receiving the SSI stipend to the higher SSDI stipend, they maintain their eligibility for Medicaid. This is extremely important to know because, as stated earlier, the Medicare coverage under SSDI has a two year waiting period. Read two stories HERE of two parents’ experiences with this important process.
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