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Can you receive Social Security Disability if you live in a nursing home?

| Oct 14, 2014 | Social Security |

At some point, many people who collect Social Security Disability or Supplemental Security Income will rely on assisted care in a nursing home or similar facility. Unfortunately, changes in living arrangement can affect an Illinois resident’s SSI and SSD benefits. Staying in certain facilities can reduce benefit amounts or even affect benefit eligibility.

Types of facilities

Need-based SSI payments can be reduced if the recipient also collects other forms of income or support. Living in public facilities and facilities that accept Medicaid payments can lead to the reduction or outright loss of payments. The SSA uses the following criteria to determine how a nursing home stay affects an adult’s SSI disability benefits:

  • If Medicaid pays for more than half of the cost of a person’s nursing home care, the person can only receive reduced benefits. Individuals can receive $30 per month, while married benefit recipients can receive $60 per month.
  • If a person lives in a public nursing facility, he or she loses eligibility for SSI disability payments. The amount of the cost covered through Medicaid is irrelevant.
  • If a person lives in a private, non-Medicaid facility, the person can theoretically receive SSI benefits. However, people who can afford care in these facilities typically do not meet SSI income requirements.

The SSA applies different rules for children younger than 18. Even if Medicaid or private insurance covers more than half of the child’s care costs, the child can receive a base payment of $30 per month.

Temporary stays

Adults may be able to keep their full disability benefits if they will be in a nursing home for less than 90 days. A doctor must state in writing that the stay will not last longer. Additionally, the benefit recipient must tell the SSA he or she needs continued benefits to maintain a home or living arrangement.

These “temporary institutionalization” benefits are available to adults entering public facilities or institutions that accept Medicaid payments. Children entering any type of facility may also qualify for these benefits.

After the end of a longer stay, a person whose income and disabling condition meet SSI criteria may qualify for benefits. However, the SSA’s eligibility review and decision-making processes prevent immediate benefit approval. The SSA allows nursing home residents expecting release to use a prerelease procedure and apply for benefits before the planned date. This can help expedite benefit disbursal.

Benefit recipients should advise the SSA when they are planning to enter or leave nursing homes. Giving notice upon entering the nursing home is especially important. This gives the recipient the opportunity to provide information about the length of the stay and the nature of the facility. People who fail to give notice risk benefit termination.