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.

I'm a caseworker who's dealt with this exact scenario many times. Here's what you absolutely need to know: Ohio has what's called the "DAC Medicaid continuation" provision under OAC 5160:1-3-05.6. When your dad files at 70 and your sister's DAC increases, she should NOT lose Medicaid if she was previously eligible for SSI. Here's the critical step everyone's missing: You need to file a "Medicaid Protection Request" form (JFS 07200) WITH the county office BEFORE your dad files for Social Security. This form specifically addresses benefit increases for DAC recipients. Also, make sure the county office runs her case through the CRIS-E system using the DAC eligibility code. Many caseworkers don't know to do this automatically. One more thing - if by chance she does temporarily lose coverage, Ohio allows retroactive reinstatement for up to 90 days for DAC recipients if the proper protections should have applied. But prevention is always better than cure. The phone number for Ohio Medicaid's DAC specialist unit is 1-800-324-8680 ext. 47291. They're the ones who really know these rules inside and out.

This thread has been incredibly helpful! I'm actually dealing with a similar situation with my nephew who receives DAC benefits. Reading through all these responses, I wanted to add one more resource that might be useful - the Ohio Disability Rights organization (disabilityrightsohio.org) has advocates who specialize in benefits issues and can help navigate these complex Medicaid/DAC interactions if you run into problems with the county office. Also, I learned the hard way that timing really matters here. When my nephew's DAC benefits increased due to his father's retirement, we waited until after the increase took effect to contact Medicaid, and it created a gap in coverage that took months to resolve. The advice about filing the Medicaid Protection Request BEFORE your dad claims is spot-on. One last tip - if you do end up needing to appeal any Medicaid decisions, Ohio has a expedited appeal process for people who might lose medical coverage due to benefit changes. The deadline is only 10 days after receiving a negative decision, so don't wait if something goes wrong. Your sister is lucky to have someone advocating for her like this. The system is complicated but there are definitely protections in place for DAC recipients.

I'm new to this community but wanted to share what I learned from my own experience with this exact situation. My brother receives DAC benefits and we went through this when our dad claimed at 70 last year. The key thing that saved us was getting ahead of it. We contacted the county Medicaid office about 3 months before dad was planning to file and explained the situation. They were able to run projections and confirm he'd qualify for the DAC Medicaid protections before any changes actually took effect. One thing I didn't see mentioned yet - make sure to ask about Ohio's "Medicaid spenddown" option as a potential backup. Even if your sister temporarily loses regular Medicaid eligibility due to the income increase, she might still qualify for Medicaid with a spenddown that covers her medical expenses. It's not ideal, but it can serve as a safety net while you work through the DAC protection paperwork. Also, don't be discouraged if the first caseworker you talk to seems confused about DAC rules. We had to escalate to a supervisor twice before finding someone who really understood the process. The specialist number someone posted earlier (1-800-324-8680 ext. 47291) is gold - they walked us through everything step by step. Your sister is fortunate to have you looking out for her. The system is definitely navigable with the right preparation!

As someone new to this community, I wanted to thank everyone for sharing such detailed and helpful information about DAC benefits and Medicaid protections. Reading through all these responses has been incredibly educational! I'm actually dealing with a somewhat related situation - my adult disabled son receives SSDI (not DAC) and we've been worried about how changes to family income might affect his benefits. While his situation is different, many of the resources mentioned here like Ohio Disability Rights and the importance of getting everything documented in writing seem universally applicable. One question for the group: do any of these Medicaid protections apply to SSDI recipients as well, or are they specifically for DAC beneficiaries? I'm wondering if there are similar "protected group" categories for other types of Social Security disability recipients. Also, I wanted to echo what others have said about being persistent with caseworkers. We've learned that having specific program names, form numbers, and reference codes makes a huge difference when advocating for our family members. This thread is a goldmine of that kind of actionable information. Thanks again to everyone who took the time to share their knowledge and experiences - it's clear this community really looks out for each other!

Welcome to the community! I just wanted to add my experience as someone who recently navigated this exact situation with my adult daughter who receives DAC benefits. The advice in this thread is absolutely spot-on, especially about filing the Medicaid Protection Request (JFS 07200) BEFORE your dad claims. We made that mistake and ended up with a 2-month gap in coverage that was stressful for everyone involved. One additional tip I'd offer: when you do contact the Ohio Medicaid DAC specialist unit at that number provided (1-800-324-8680 ext. 47291), ask them to email you a summary of your conversation. Having that documentation proved invaluable when we had to work with our local county office later. Also, if your sister has any ongoing medical appointments or prescriptions that can't be interrupted, make sure to mention that specifically when filing the protection request. They can sometimes expedite the process for people with urgent medical needs. The system definitely works when you know which buttons to push, but it requires being very proactive. Your sister is lucky to have such a dedicated advocate! Feel free to update us on how it goes - these real-world experiences help everyone in the community.

As someone new to this community, I wanted to share a resource that might be helpful for situations like this. I recently discovered that many state disability advocacy organizations have benefits specialists who can help navigate these complex interactions between different programs. In Ohio specifically, there's also the Statewide Independent Living Council (SILC) that provides benefits counseling services. They often have staff who specialize in exactly these kinds of DAC/Medicaid crossover situations and can sometimes even attend meetings with caseworkers to help advocate. I'm just learning about all these programs myself, but it seems like having multiple layers of support and advocacy can really make a difference when dealing with such complicated benefit rules. The phone numbers and form references everyone has shared here are invaluable, but sometimes having a local expert who can walk through the process with you face-to-face can be equally helpful. Thank you to everyone who has shared their experiences - as a newcomer trying to understand how these systems work, this thread has been incredibly educational. It's clear this community really supports each other through these challenging situations!

As a newcomer to this community, I'm amazed by how comprehensive and helpful this discussion has been! I don't have direct experience with DAC/Medicaid interactions, but I wanted to thank everyone who shared their knowledge and real-world experiences. What strikes me most is how many specific resources and contact numbers have been provided - from the Ohio Medicaid DAC specialist unit (1-800-324-8680 ext. 47291) to the JFS 07200 form for Medicaid Protection Requests. Having these concrete action steps makes what seemed like an overwhelming situation much more manageable. For other newcomers who might find this thread later, it's clear that the key takeaways are: 1) Be proactive and file protection requests BEFORE benefit changes take effect, 2) Don't get discouraged if the first caseworker doesn't understand DAC protections - escalate to specialists, 3) Document everything in writing, and 4) There are multiple advocacy organizations available to help navigate these complex situations. Thank you to everyone, especially the caseworker who provided the detailed procedures and the many community members who shared their family experiences. This is exactly the kind of supportive, informative discussion that makes online communities valuable for people facing challenging benefit situations.