WAG 15-04-03-c.

For a community medical client, monthly SSI benefits are protected income. Do not apply SSI toward medical care costs. When determining countable monthly income, deduct SSI benefits from total gross income and compare the remainder to the Standard.

See PM 08-02-07-b for the effect of SSI lump sum payments.

Budgeting SSI for an LTC Facility Stay of 90 Days or Less

In general, when an SSI recipient enters an LTC facility, the Social Security Administration (SSA) reduces SSI benefits to $30 per month. However, if a person enters an LTC facility for an expected stay of 90 days or less, sometimes SSI benefits are not reduced.

During a stay of 90 days or less, SSI benefits are sometimes continued at the regular monthly amount for 3 full months. Receipt of the regular monthly SSI amount provides a means for the payment of some or all of the expenses to maintain a home to which the person may return upon discharge.

In order for SSA to continue SSI benefits during an LTC stay of 90 days or less:

  • the person must request the continuation in writing from SSA,
  • a physician must certify that the person is expected to be in the LTC facility for 90 days or less,
  • the person must have expenses to maintain a home to which they may return upon discharge, and
  • SSA must approve the request.

SSA will notify the person if SSI benefits are continued at the regular monthly amount for 3 full months. The notice contains the beginning month of the 3-month period.

If a person informs the Family Community Resource Center that SSI benefits are continued at the regular monthly amount due to an LTC stay of 90 days or less, request verification of the notice from SSA. Once proof is received, do not budget SSI in excess of the $30 LTC Standard for 3 full months beginning with the first month SSI benefits are continued at the regular monthly amount. Complete adjustments as needed.

If the LTC stay exceeds 90 days, SSA reduces SSI benefits to $30 the month following the month the 3-month period ends.

Budgeting SSI for Other than an LTC Stay of 90 Days or Less

Apply SSI in excess of the $30 Long Term Care Standard towards needs for the month of receipt when a medical client is a resident of an LTC facility, DHS facility, or other medical facility. See PM 15-06-02 for policy on the Long Term Care Standard.