Can Medicaid eligibility be lost when DAC benefits increase after parent claims SS at age 70?

This is a complicated but important question. DAC (Disabled Adult Child) benefits can indeed increase when the parent whose record they're drawing from claims Social Security, especially if that parent delayed until 70. The good news is there are special Medicaid protections for DAC beneficiaries called 'Pickle Amendment' protections. If your sister was eligible for both SSI and Social Security benefits in the past, and later became ineligible for SSI due to an increase in her Social Security benefits (which could happen when your dad claims), she might qualify for continued Medicaid under these protections. Ohio definitely has these provisions. I'd recommend contacting your sister's Medicaid caseworker directly about this situation BEFORE your dad files. Make sure to specifically mention 'DAC beneficiary' and 'Pickle Amendment protections.'

ABSOLUTELY DO NOT let your dad file for SS until you get this figured out!!! My cousin lost his Medicaid when his DAC went up and it was a NIGHTMARE to get back!! The income limits for Medicaid in Ohio are SUPER low and most caseworkers DON'T KNOW about the special rules for DAC recipients. Your sister could lose her healthcare coverage for MONTHS while you try to straighten this out!!

I just went through this exact situation with my son last year. Here's what you need to know: 1. When your dad claims at 70, your sister's DAC benefit will automatically recalculate based on his higher amount 2. This WILL likely put her over the standard Medicaid income limit in Ohio (which is only about $941/month for an individual) 3. However, there's a special Medicaid eligibility category for people in your sister's situation called the "DAC Medicaid Protected Group" 4. To qualify, she needs to have become disabled before age 22, be receiving DAC benefits, and have lost or be at risk of losing SSI due to receiving these benefits 5. Contact both the Ohio Department of Medicaid and your county Job & Family Services office. Be very specific that this is about the DAC Medicaid Protected Group The trick is finding someone who actually understands these rules - they're complex and not every caseworker knows them well. You might need to be persistent.

have u tried calling ssa direct? they cn tell u exactly how much the new payment will b and then u can take that 2 medicaid office. my daughter gets dac 2 and we did this b4 my husband started his ss

Have you tried using Claimyr to get through to Social Security? It's been a lifesaver for me with these kinds of complex benefit questions. I was in a similar situation trying to figure out SSA rules for weeks and couldn't get through. I used their service at claimyr.com and got connected to a real agent in about 15 minutes. They have a video showing how it works: https://youtu.be/Z-BRbJw3puU I found that speaking directly with an SSA representative was the only way to get accurate information about how the DAC benefit would be recalculated. The agent was able to run calculations based on your father's projected benefit at 70 and tell me exactly how it would affect the DAC amount.

just wondering but did your sister ever check if she qualifies for a ABLE account? might help w/ the medicaid situation too since money in ABLE doesnt count for medicaid limits in ohio

First, to directly answer your question - yes, DAC benefits can increase to a level that affects Medicaid eligibility. However, as others mentioned, there are protections in place. I work with clients in similar situations frequently, and here's what I recommend: 1. Contact Ohio Medicaid and specifically ask about the "Medicaid Buy-In for Workers with Disabilities" program as another potential option 2. Look into whether your sister might qualify for a 1619(b) status if she has any work history 3. Get a benefits analysis done through Ohio's Work Incentives Planning and Assistance (WIPA) program 4. Request a PASS plan evaluation from your local SSA office Also, make sure all paperwork clearly indicates she's a DAC recipient who previously received SSI. This status triggers specific protections under both federal and Ohio state law. The system is complex but navigable if you know which specific programs to ask about.

To answer your follow-up question - the timing of when she received SSI can matter for certain protections. The key thing to verify is whether she meets the criteria for Section 1634(c) of the Social Security Act (this is the actual law behind what many call the DAC Medicaid Protection). Specifically, to maintain Medicaid eligibility under this protection, your sister must: 1. Be entitled to DAC benefits 2. Have lost SSI due to receiving or increasing DAC benefits 3. Still meet the disability criteria and other non-financial SSI eligibility requirements Ohio has implemented this federal protection. The fact that it's been 6 years since she received SSI doesn't automatically disqualify her, but you'll need to verify with Ohio Medicaid exactly how they apply this rule.

In response to your question about documentation, here's what I recommend bringing to your Medicaid meeting: 1. SSA Award Letters - both the original DAC determination and any subsequent adjustments 2. Documentation showing when/why she stopped receiving SSI (ideally the SSA notice) 3. Any documentation about her original disability determination 4. Bank statements showing current DAC deposits 5. A calculation or estimate of what her increased DAC benefit will be after your father files at 70 Also, specifically request that the caseworker document in her file that she's a DAC recipient potentially eligible for 1634(c) protections. This creates a paper trail if you need to appeal later. Be prepared for the caseworker to be unfamiliar with these protections - they're not commonly dealt with. You might need to request a supervisor or specialist who handles unusual Medicaid categories.