I know a few people in Texas have experienced this difficulty, so I'd like to share it.
A disabled person in his 30s receives SSI and Medicaid in Texas. A few months ago, he switched from SSI to receiving social security for disabled adult child (DAC) because the latter amount is higher. Then Texas Health and Human Services (HHS) notified him that he will lose Medicaid by end of month because his Medicaid qualification is with SSI.
I called Texas Medicaid help line (2-1-1) and the rep said that's the rule and there's nothing they can do. I showed up in the local HHS office in Austin, and the rep said the same. The rep is the manager so there is no higher supervisor to talk to.
I sat down in the wait area, started looking up the rules (thank you ChatGPT and Gemini), and went back to the rep with the relevant rule. Eventually he found someone in that office that knew about it, worked through various (software?) issues and we get the Medicaid back. Not bad for a 2-hr work after stepping into the HHS office.
The rule is in "A-2310 Disabled Adult Children (DAC)" of Medicaid for the Elderly and People with Disabilities Handbook . Specifically,
Loss of SSI payments can result in loss of Medicaid coverage. To preserve Medicaid coverage for certain groups of persons who lose SSI payments, Congress enacted special Medicaid continuation provisions. Persons denied SSI due to certain increases in Social Security benefits may continue to be eligible for Medicaid coverage. (more in that page)
The net change is to move from Medicaid based on SSI, to Medicaid based on elderly and disabled adults. For the latter, the specific code HHS needs to use is RSDI (Retirement, Survivors, and Disability Insurance).
Benefit from RSDI, similar to SSI, has a limit of no more than $2,000 asset (not income) in the checking account, among others. What if someone's DAC benefit is more than $2000? Well, HHS determines the amount at 12:01am of the first day of a month (public information, nothing shady). DAC check comes in around 3rd of a month. So as long as it is spent before the first of next month, one is fine.
A disabled person in his 30s receives SSI and Medicaid in Texas. A few months ago, he switched from SSI to receiving social security for disabled adult child (DAC) because the latter amount is higher. Then Texas Health and Human Services (HHS) notified him that he will lose Medicaid by end of month because his Medicaid qualification is with SSI.
I called Texas Medicaid help line (2-1-1) and the rep said that's the rule and there's nothing they can do. I showed up in the local HHS office in Austin, and the rep said the same. The rep is the manager so there is no higher supervisor to talk to.
I sat down in the wait area, started looking up the rules (thank you ChatGPT and Gemini), and went back to the rep with the relevant rule. Eventually he found someone in that office that knew about it, worked through various (software?) issues and we get the Medicaid back. Not bad for a 2-hr work after stepping into the HHS office.
The rule is in "A-2310 Disabled Adult Children (DAC)" of Medicaid for the Elderly and People with Disabilities Handbook . Specifically,
Loss of SSI payments can result in loss of Medicaid coverage. To preserve Medicaid coverage for certain groups of persons who lose SSI payments, Congress enacted special Medicaid continuation provisions. Persons denied SSI due to certain increases in Social Security benefits may continue to be eligible for Medicaid coverage. (more in that page)
The net change is to move from Medicaid based on SSI, to Medicaid based on elderly and disabled adults. For the latter, the specific code HHS needs to use is RSDI (Retirement, Survivors, and Disability Insurance).
Benefit from RSDI, similar to SSI, has a limit of no more than $2,000 asset (not income) in the checking account, among others. What if someone's DAC benefit is more than $2000? Well, HHS determines the amount at 12:01am of the first day of a month (public information, nothing shady). DAC check comes in around 3rd of a month. So as long as it is spent before the first of next month, one is fine.
