DAC – Disabled Adult Child
Keep Medi Cal & Increased benefits from Parents Retirement Benefits

What is the Social Security SSI DAC – Disabled Adult Child Program?
You can keep Medi-Cal – Pickle Program 

Get SSDI on your Parents Work History  ssa.gov 

The DAC – Disabled Adult Child program provides full-scope, no cost Medi-Cal to qualifying adults who receive “Social Security Disabled Adult Child (DAC) benefits.”

An adult is entitled to receive Disabled Adult Child benefits if:

• that adult is unmarried;
• has a disability that began before the age of 22
• and was dependent on his or her parent at
  • the time of application,
  • the time of the parent’s death, or
  • at the time the parent’s own period of disability began ^{Sec. 216. Other definitions}

To qualify as a Medi-Cal Disabled Adult Child an individual must be entitled to receive Title II Disabled Adult Child benefits and must have had and lost SSI because of eligibility for these Title II benefits.

Individuals first receive Social Security DAC payments at the time of the retirement, disability or death of a parent.

When this occurs, an individual who is receiving SSI can begin receiving a DAC payment that is higher than the SSI payment rate. This makes the individual ineligible for SSI and for SSI-linked Medi-Cal.

Individuals who receive “Social Security DAC” benefits can qualify for full-scope, no cost Medi-Cal if they:

• Received SSI in July 1987 or later;
• Initially qualified for Title II DAC benefits, or qualified for an increase in Title II DAC benefits, on or after June 1, 1987; and
• Would be eligible for SSI now but for either:

° the current receipt of Title II DAC benefits which they first became eligible for while they were receiving SSI, or
° the increase in Title II benefits because of COLAs since they last received both Title II benefits and SSI.

In order for an individual with Title II DAC benefits to continue to receive MediCal with no Share of Cost, the Social Security Title II income is disregarded when calculating Medi-Cal eligibility. Under federal law, the individual is treated for Medicaid purposes as if they were still an SSI beneficiary.

Getting and Keeping DAC Medi-Cal

Any individual described above who qualifies should be able to get Medi-Cal either as a continuing benefit when she loses SSI or, if later, as a new applicant under the Medi-Cal DAC Program. The state periodically sends counties lists of Title II DAC recipients whose SSI/SSP has been or is being terminated.  The counties are required to contact the recipients to see if they need assistance in completing the forms required for the application process.  Eligible individuals should remain eligible as long as they meet all the other SSI eligibility rules.  ^{DAC Program Page 84 – Non Magi Medi-Cal 3.71}

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Eligibility Group Requirements*: An individual who was receiving Supplemental Security Income (SSI) benefits and who meets the following:

• Is at least 18 years of age;
• Has blindness or a disability which began before the age of 22;
• Has been receiving Supplemental Security Income (SSI) based on blindness or disability; and
• Has lost Supplemental Security Income (SSI) due to the receipt of Social Security benefits on a parent’s record due to the retirement, death or disability of a parent.

*If the person meets all of the above criteria, they may qualify as a Disabled Adult Child under Section 1634 of the Social Security Act (regarding DAC). This designation comes from the Social Security Administration. Eligibility for Medicaid may continue as long as the person is determined blind or disabled. However, if the person receives income from another source or exceeds the resource limits, they may become ineligible for Medicaid coverage  ^{See the rest of the New Jersey 2 page explanation}

Resources & Links

•  explanation on Sellers Law Firm website 
• Hill & Ponton  
• See the Official Social Security Booklet on benefits for Children with Disabilities
• See also Medicare Part B Premium Forgiveness
• IHSS In Home Supportive Services
• Department on Disability, on behalf of the City of Los Angeles
• special needs answers.com/
• 
• CA Health Advocates.org  HI CAP
• 
• You can stay on your parents health insurance after age 26 …  our webpage
• Special Needs Trusts  our webpage
• SSI & SSDI  our webpage
• Read you actual insurance policy  our webpage 
• Medi Cal Aged & Disabled Program  our webpage

#Pickle Amendment

What is the Pickle Program?

• When a person receives SSI and one of their parents retires, becomes disabled, or dies, the person switches from receiving SSI to receiving SSDI. Sometimes a person can receive both SSDI and SSI.
• Getting SSDI usually means you’ll get more money. When that happens, people are sometimes told that they will lose their Medi-Cal coverage, or that they will have to pay a higher share of cost because their income is too high. Some people are even told by staff at the Social Security Administration or Medi-Cal that they will lose their Medi-Cal.
• The Pickle 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 Medi-Cal –  Medicaid.   FAQ  ^{2 page flyer}
• The DAC Medi Cal program maintains the status quo with respect to Medi-Cal by continuing to provide categorical Medi-Cal so long as the individual would be eligible for SSI if the individual were not receiving the DAC Social Security payments. The DAC Medi-Cal program, like the Pickle program, also provides protection from loss of SSI-linked Medi-Cal caused by Social Security COLAs. This second part of the DAC Medi-Cal program is sometimes called the “Pickle DAC” or “pseudo Pickle DAC” program.
•  The Employment for Disabled Americans Act of 1986 (Public Law 99-643) requires states to continue Medicaid coverage when an individual who became disabled before age 22 and received SSI becomes eligible for SSDI or has an increase in SSDI benefits. Such disabled adult children continue to be considered SSI recipients for Medicaid purposes.
• Disabled Adult Child (DAC) Medi-Cal Program Benefits
• A Quick and Easy Method of Screening for Medicaid Eligibility under the Pickle Amendment: 2023 Update

Instructions on how to move from SSI to SSDI and
#keep Medi Cal & Medicaid 2 pages

Resources & Links 

• Learn More CA Disability 101
• Guide to Medi Cal Programs – Chcf  Page 43
• Poverty Law.org
• Guide to Disability Rights Laws Ada.Gov
  • Fair Labor Standards Guide by ChamberofCommerce.org
• special needs answers.com
• Rank vs Lynch