Medicaid Policy
Medicaid Policy
Contact DHHS Policy Specialist for Previous Policy (337 was renumbered to 330-4 as of November 1, 2017)
Previous Policy for Determining Eligibility for Widow Protected Group (337-1 incorporated into 330-4 as of November 1, 2017)
Protected Disabled Widows and Widowers
Disabled people who lose SSI because they receive widow/widower benefits from SSA or an increase in these benefits can receive Medicaid in this protected group.
There were two groups of disabled widows and widowers who received protected Medicaid.
People in the first group used to receive SSI benefits until SSA changed the way it calculated some survivor's benefits. This caused their SSA amount to increase enough to make them ineligible for SSI. SSA identified these individuals and provided lists to the states. These people must have applied for Medicaid by December 1, 1988. There are no longer any people who qualify in this group.
People in the other group receive protected Medicaid beginning with the month after they lose their SSI and are receiving a widow's benefit from Social Security. The protected Medicaid may last until they become entitled to Part A Medicare. See below to determine eligibility for this group of disabled widows and widowers.
How to Identify Disabled Widows and Widowers
Check the individual’s Social Security benefit claim number. The claim number will be the spouse's SSN with a D or a W at the end. To get widow or widower’s benefits a person has to be at least 50 years old and disabled. Widow's age 60-64 can also receive Social Security widow/widower benefits, but to qualify for this protected group, they had to have received SSI, continue to be disabled and are not entitled to Medicare Part A.
C. Eligibility Criteria
o Be receiving a Social Security benefit for disabled or aged widows or widowers. (Benefits are available to "early" widows from age 60. These are not based on disability, but receipt of SSI before age 65 is based on disability.)
o Have received SSI for the month before the widow(er) benefits began or increased.
o Have lost SSI when the widow or widower benefits started or increased; or lost SSI because of an increase in some other income.
o Be ineligible for Part A Medicare.
o Have countable income less than the SSI payment for one person. Do not count the widow/widower benefit to determine the countable income.
o Continue to be disabled. For a widow/widower under age 60, Social Security does continuing disability reviews. Do not ask for an MRB disability review while the individual is under age 60 and is receiving widow/widower benefits.
o For a widow/widower age 60+, Social Security will not do continuing disability reviews after the SSI stops. Benefits are based on age, not disability. However, because the widow/widower was receiving SSI before becoming eligible for the widow benefit, disability was established by SSA. For a widow/widower over age 60, complete a disability review through the Medicaid Review Board 12 months after the SSI stops.