Supplemental Security Benefits (SSI)

Is Medi-Cal  #automatic  linked for SSI – Supplemental Security Benefit beneficiaries – recipients?

***Yes,  according to

• Nolo.com *
• Disabilty Secrets.com *
• CA Health Care Advocates *
• Western Poverty Law Center 
• See our webpage on
  • DAC Disabled Adult Children & Pickle Amendment
  • Medi Cal

Many individuals receive SSI due to poverty (over 65) and others receive SSI due to disability.

FAQ’s “SSI – Medi-Cal automatic qualification”

• i lost my medical [Medi-Cal] card that i got with my ssi  how do i get a new card?
  • See prior FAQ
  • Did Medi Cal assign you to a private insurance company? Then you would check their website.
• My brother and sister-in-law are on Medi-Cal… Can they both get SSI…they have no other income except SS?
  • I don’t quite understand your question. If they are disabled and qualify for SSI, then Medi-Cal is automatic.
  • What do you mean by SS income? Please be specific.
  • Maybe you are asking if SSI has income limits, as opposed to Medi-Cal. See the links & brochures on this page.
• I am a menifee ca resident receiving ssi..  when my wife receive her ssi this jan 2020, i now received a letter informing me my medi-cal will be stopped jan 31, 2020.. ..  why is this ?
  • My guess would be that you are over the MAGI Income Limit 138% for Medi Cal.
  • Do you qualify for an exemption under the Pickle Amendment?
  • Please send us a copy of the letter and your latest tax return. We are prohibiting from accepting hearsay evidence.
• I went from SSI TO SSDI as a disabled adult child or whatever its called  i was disabled before 22 years old. i got ssi at 20  my dad retired fully last December – next thing you know they moved me from SSI TO SSDI
  • It’s my understanding that SSDI is a better program to be on than SSI, mainly that it pays more income.  While SSI provides automatic enrollment in Medi-Cal, SSDI gives you automatic enrollment into Medicare, after 2 years.   Check our Medi-Cal eligibility pages, Western Poverty Law, the Guide to Medi-Cal Programs and our resources page.
• What about this document on the pickle amendment on the SCDD State Council on Disability Website?
  • See our write up on the Pickle Program

Social Security Disability Insurance #SSDI

The  Social Security disability program SSDI  for an average family is equivalent to a private disability insurance policy worth over $233,000.  Social Security pays benefits to people who cannot work because they have a medical condition that is expected to last at least one year or result in death. ^{(ssa.gov #10029)}

Once you have received Disability benefits for two years you will automatically be covered under Medicare  Parts A & B  ^{ssa.gov # 10029} * (there is a $170 premium for Part B – If you are low income there may be ways to get that paid for you) and we can then help you enroll in a

If you’re interested in Medicare Advantage Plan (NO PREMIUM!), Part D Rx and Medicare Supplemental Medi-Gap Plans visit those webpages and contact us   be sure to contact us RIGHT away, as there are deadlines!

Resources, Links & Bibliography

• Disability Benefits #10029
• Fact Sheet SSDI
• Our webpage on DAC Disabled Adult Child Program
• Adult Children With Disabilities Can Qualify For Benefits on Parents’ Work Records
• disability secrets.com/how-much-can you get for SSDI? 

Complex FAQ on Overpayments

• I have a minor child. His father (we did not live together) was on ssdi. My child was given benefits through his father’s ssdi. I was the representative payee and received his payments on a direct express card starting in 2014.
  • In 2017 I was approved for ssi (physical disability). The SSA put my benefits onto the same card as the one i used for my child. I questioned how i was to account for sending of my benefits if his were merged on the same card. SSA said there would be no conflicts. Reporting requirements for family member representatives was ended in 2018.
  • His father died in 2021. SSA changed my Childs benefits to ssdi survivors benefits.
    Direct express continued to be the card used for both our benefits.
  • Because we were not on the same benefit as a family household, SSA did not adjust either of our payments.
    • This did not become any issue until two months ago.
  • Now SSA says I owe over $13,000 because they claim that stocks I purchased for my child, in my name, are considered assets or resources. They are using the direct express card beginning monthly balance as well as the value of those stocks, to calculate the total resources or assets amount.
  • SSA does not pay my benefits on the first of every month. Some months they pay benefits on the last day of the month, for the next month.
    They are using the ending balance as well.
    They are combining the current market value of thr stocks with my bank balances to say I am over the limit of $2000.
• They are not acknowledging these facts:
  • The time period in which they say I was overpaid is for a year in which I received no benefits and for a one month time period in which they had paid me an underpayment amount in the previous month at the end of that month; which caused my direct express balance to be $400 positive on the first day of the next month.
  • Forgive the detailed explanation.
    I worded it how they paid it and how they themselves would describe it.
    If they were paying attention.
• I understand that sometimes SSA uses a look back period to determine current eligibility.
• My personal feelings aside; they’re saying I was overpaid for an entire year in which they gave me literally nothing. They’re calculations for each month, using my direct express card balance; does not seem correct. If my benefits and ny child’s benefits are om the same account; and my child’s benefits are not needs based income nor have any resources assets or income qualifications; how can they do math like this?
• If they do not consistently pay benefits to ssi recipients on the first of the month, and sometimes pay them on the last day of the previous month; how can they say that person has a balance that is considered a resource or asset or over income?
• They noticed me with 3 separate letters all dated the same day and received the same day. Each letter says something different for ways in which I can respond and time limits to do so.
• Each way is not accurate nor do they provide due process fairly. One notice says I have 60 days to file for an informal meeting with the field office person who sent the notice. But that if I don’t do so with in 30 days they will not stop the overpayment collection effort if reducing my benefits.
• Another letter says I have 30 days to request to meet with that person.
  • One letter does provide details about the pandemic period waiver. But that period was March 2020 to September 2020. The overpayment is for September 2021 to August 2022 and for April 2023. The pandemic waiver obviously does not apply.
  • None of the letters provide for regular waiver, reconsideration, hearings at a hearing level with an alj, appeals with the appeals council; nothing.
  • The 3rd letter does not say anything.
• None of this seems correct.
•  
• SSA noticed me of an overpayment decision in February.
  • There’s a lot of conflicts with it.
• The main one being. I did not receive any benefits for the majority of the time period they say I was overpaid. Four months of the time period, I did revieve payments.
• The whole thing is being based on several factors.
  • The beginning and ending monthly account balance on my card.
  • The monthly value of stocks I had purchased for my child. Purchase occurred during the time period in which my benefits were not paid.
  • I sold most of the stocks at a huge loss during three of the months they say I was overpaid.the reason was due to an emergency need which they verified as legitimate.
  • The sales brought the stocks value down to maybe $1100. The remaining stocks value fluctuated for a few months never going over $1700. They then plummeted to less than $1000.
  • The reason I felt I could purchase stocks for ny child was because it was his money.
  • The reason I felt it would not be a conflict was because, my child revieves ssdi survivors child benefits, which allow for savings to occur. In fact SSA tells representative payees to save some of the child’s benefits if possible.
  • The money used was gifted to my child.
• One month of the stated overpayment period, occured because my direct express balance was $400 at the beginning of the month. This was because SSA had paid me an underpayment amount a couple of weeks earlier.
•  
• I recieved no benefits from March 2021 until June 2022.
• I recieved my child’s ssdi survivors benefits in my name as representative payee.
• SSA  pays both of our benefits onto the same direct express card.
• There is no separation once the benefits are in direct expresses hands.
  • All of this seems very wrong.
• But may  biggest concern is how they are choosing to use any balance on the direct express card, to count against me. Several of those months they show the balance as less than a dollar or less than 1 hundred dollars.
  • Mainly it’s amounts like a few dollars.
  • If they themselves put our payments on to the same card, despite my questioning future accountability concerns; they’re overstepping their boundaries.
• If the monies on that card belong in part to a recepient that has no reporting requirements and no resources, assets or income limits; how can they say that the representative payee, whos benefits are the other part of those monies, is over income, resources or assets?
• If I as a representative payee, make efforts to save for the ssdi survivor recepient, how can they say that is my resource or asset or over income?
• How can they count my benefits in the same accounting used to calculate assets and resources?
• These questions are based on if I actually was paid for the whole time.
• They apply for the months I was paid as well.
  .
• ANSWER This question is way beyond my pay grade. I guess all I can do is give you some research and definitions. I also have an attorney referral section above.
  • What  is   your   Question  for   me?
    • Overpayments Publication 10098
    • ssa.gov/overpay-ussi
    • disability rights ca.org/ssi-overpayments
    • How many months were your resources over $2k?
      • ssa.gov/resources
      • On the other hand, you are correct SSDI has no asset limit
    • Appeals