Losing Medicaid when switching from SSI to SSDI DAC benefits - need affordable healthcare options ASAP

Your daughter should qualify for Medicare after 24 months of receiving DAC benefits, but that doesn't help you now with the immediate Medicaid gap. What you need to look into is your state's Medicare Savings Program or possibly the 1619(b) Medicaid continuation provision. Many states have programs that allow people to keep Medicaid even after they lose SSI due to increased income. Also, she might qualify for Extra Help with prescription costs through Social Security. I'd recommend calling your state's disability services department immediately - they often have case managers who can help navigate this exact situation. Also check if your daughter's current healthcare providers have patient assistance programs to bridge the gap.

when my son got switched from SSI to SSDI his medicaid stopped too but we found out he could get it back by applying through the state directly not through social security. call your state mediciad office not SSA they dont handle that part. also ask about patient assistance programs from the drug companies my son gets 2 meds for free that way

You're dealing with what's known as the "Medicare waiting period gap" - it's a horrible policy flaw in the system that leaves many disabled people without coverage during the 24-month Medicare waiting period after starting SSDI (or DAC in your case). Here's what you need to do IMMEDIATELY: 1. Contact your state's Health Insurance Assistance Program (SHIP) - they provide free counseling specifically for Medicare/Medicaid issues 2. Apply for Medicaid under your state's disability-specific programs (many states have alternative eligibility pathways besides SSI) 3. If your daughter's income now exceeds Medicaid limits, look into your state's "medically needy" program or spend-down options 4. Contact the pharmaceutical companies directly - most have patient assistance programs for those who can't afford medications 5. Check if your local community health centers offer sliding-scale mental health services The most frustrating part is that SSA and Medicaid offices often don't communicate well and don't proactively tell people about these options. You have to advocate aggressively and know what to ask for.

We went through this NIGHTMARE last year with my brother. After WEEKS of calling and getting nowhere with SSA or Medicaid, we finally tried Claimyr (claimyr.com) to actually get through to a human at Social Security who could help coordinate with Medicaid. The agent we reached explained that my brother qualified for continued Medicaid under special rules and helped send the right documentation to our state Medicaid office. Check out their video about how it works: https://youtu.be/Z-BRbJw3puU Seriously saved us when we kept getting disconnected calling the regular SSA number. The agent we reached knew EXACTLY what forms to fill out for the Medicaid continuation.

wait i'm confused does DAC mean disabled adult child? i thought that was different from SSDI?? my nephew gets ssi but will he qualify for my brothers disabled adult child thing when my brother retires next year??

I'm so sorry you're dealing with this!! The system is AWFUL and they don't tell you about these gaps until it's almost too late! My daughter almost ran out of her seizure meds during our transition. One thing to check IMMEDIATELY is whether your state has the "Medicaid Buy-In" program. My daughter qualified for that even though her SSDI was too high for regular Medicaid. She pays a small premium ($57/month in our state) but it covers EVERYTHING her regular Medicaid did.

Another critical option to pursue: If your daughter was receiving both SSI and Medicaid, she may qualify for Medicaid under Section 1619(b), which allows people to maintain Medicaid eligibility even after they lose SSI cash benefits due to increased income (like from DAC). This provision was specifically created for situations like yours. To qualify under 1619(b), your daughter must: 1) Have been eligible for SSI cash payments for at least 1 month 2) Still meet the disability requirement 3) Still meet all non-disability SSI requirements except for income 4) Need Medicaid to work (or in her case, likely to maintain independence) 5) Have gross earnings below your state's threshold Many SSA offices don't automatically tell people about this option. You need to specifically request a 1619(b) determination. This could be the fastest path to maintaining her Medicaid without interruption.

same thing happened to my cousin when he got DAC but he did end up qualifying for both medicare AND medicaid eventually. the 24 month waiting period for medicare is awful though!!!!! call your state pharmacy assistance program in the meantime they might be able to help with medication costs