Social Security family maximum limits with DAC benefits - will my disabled son lose Medicaid?

Yes, DAC benefits absolutely count toward the family maximum even if your adult child lives separately. The family maximum is typically between 150%-180% of the worker's PIA, regardless of where beneficiaries live. For high earners like your husband ($3600), it's closer to 150%.You'll need to calculate the Family Maximum Benefit (FMB) using the formula on your husband's earnings. But very roughly, with his PIA of $3600, the family max might be around $5400 (150%). That would mean all auxiliary benefits (your spousal benefit if you're taking one + your son's DAC) would be proportionally reduced to fit within what's left after your husband's benefit.Very important: DAC beneficiaries CAN keep Medicaid eligibility even when switching from SSI through special protected status under Section 1634(c) of the Social Security Act. This is CRUCIAL for your decision.

Thank you for explaining this! So if I understand correctly, even if my son gets DAC instead of SSI, he could keep his Medicaid? That's a huge relief because his healthcare needs are significant.I'm still confused about the math though. I won't be taking a spousal benefit - I'll be getting retirement on my own record ($3000). Does that mean my son could get the full $1800 DAC amount (50% of my husband's $3600)? Or would he still be limited somehow by the family maximum even if I'm not taking a spousal benefit?

OMG I just went through this EXACT same thing with my daughter!!! The family max is SO confusing. Here's what I learned: If you're getting benefits on your OWN record (not as a spouse), then your benefit doesn't count toward your husband's family maximum. The family max only affects people drawing on HIS record.My daughter moved from SSI to DAC last year and it was the BEST DECISION EVER. She gets about $800 more per month now! But getting through to SSA was IMPOSSIBLE until I found this service called Claimyr (claimyr.com). They got me through to an actual human at SSA in like 20 minutes when I'd been trying for weeks. They have a video showing how it works: https://youtu.be/Z-BRbJw3puU AND YES, your son can keep Medicaid! There's a special protection called the

Thank you for sharing your experience! It's so helpful to hear from someone who's been through this. I'll definitely check out that Claimyr service - I've been dreading the phone calls to SSA. And I'm relieved to hear your daughter was able to keep her Medicaid coverage. I'll make sure to specifically ask about the Pickle Amendment protection when we apply.

Am I the only one furious about how deliberately confusing the SSA makes all this?! They hide these critical benefits behind mountains of incomprehensible jargon and expect disabled individuals and their aging parents to somehow figure it all out!? I spent YEARS not knowing my son could get DAC benefits instead of paltry SSI!Just be warned - when your son switches to DAC, they'll probably mess something up. They ALWAYS do. Document EVERYTHING. Record calls if legal in your state. They messed up my son's Medicaid continuation and it took SIX MONTHS to fix while we paid out-of-pocket for his medications. The system is BROKEN.

this happened to my brother too. ssa kept saying he would keep medicaid but then the state medicaid office said he was over income limits. total nightmare. took like 4 months to fix

EXACTLY! The left hand doesn't know what the right is doing! SSA says \

Your son definitely qualifies for DAC since he has a disability that began before 22. It's usually better than SSI. My sister gets DAC and its so much better than SSI was.

Thanks for confirming! Yes, he was diagnosed at age 3, so that requirement is definitely met.

I think everyone's missing something important here. If your son gets DAC, he'll lose SSI which means he'll also lose automatic Medicaid qualification. DAC benefits are considered Title II benefits which are different from SSI (Title XVI). In some states, this means he'll have to qualify for Medicaid through different criteria. The income might put him over the limit depending on Florida's specific rules.You need to contact your local Medicaid office specifically, not just rely on what SSA says about continued eligibility. Each state implements these protections differently.

This isn't entirely accurate. While DAC (Childhood Disability Benefits) are Title II benefits, there are specific Medicaid continuation provisions for people transitioning from SSI to DAC. It's called the

Thank you for this precise information! I'll definitely write down \

To answer your follow-up question about the math: Yes, since you're drawing on your own record ($3000), that won't affect your husband's family maximum calculation.Let's do some rough math:- Your husband receives $3600 (his full PIA)- Let's estimate the family maximum at around 150% of PIA for high earners = $5400- Available for other beneficiaries on his record: $5400-$3600 = $1800Since your son would be the only other person drawing on your husband's record, and his potential DAC benefit would be $1800 (50% of your husband's PIA), this works out perfectly within the family maximum in your situation.The DAC amount would be significantly higher than his current SSI ($943), plus he can maintain Medicaid eligibility with proper handling. This looks like a good move financially, but be prepared for administrative challenges during the transition period.

And be prepared for SSA to calculate this wrong the first time! They initially told me my son could only get $600 instead of the full 50% he was entitled to. I had to FIGHT them on this for months. Don't take their first answer as gospel!

Thanks for the warning. I'll double-check their calculations carefully and be prepared to advocate if needed.

my cousin gets SSI and medicaid but his dad never worked so he cant get DAC. ur son is lucky

I'm sorry to hear about your cousin's situation. We are fortunate that my husband worked consistently. I hope your cousin is getting all the support available to him.

One important detail: When your son switches to DAC benefits, he'll have a 5-month waiting period AND a 24-month Medicare waiting period. During these periods, it's crucial that the Medicaid continuation is properly processed.Also, the process works like this:1. Apply for DAC with SSA2. When approved, immediately contact Florida Medicaid (DCF) about 1634(c) continuation3. Provide DCF with the SSA award letter showing the transition from SSI to DAC4. Request written confirmation of Medicaid continuationThe timing is critical - this must be done during the month of the change or the following month to ensure no gap in coverage. Since your son has a roommate, also consider how increased income might affect any income-based housing subsidies if applicable.

Thank you for laying out these specific steps! I hadn't considered the waiting periods or the potential impact on housing. His current living arrangement isn't subsidized, but I'll make sure to follow these exact steps with both SSA and DCF to keep his Medicaid coverage intact.

after my mom died my disabled brother had to switch from her record to my dads record and it was a mess for like 8 months. but now hes getting more money and still has medicaid. just be ready for it to take forever and keep calling them

Thanks for the reality check. I'm starting to realize I need to be prepared for a lengthy process with possible complications. I'll definitely stay persistent with follow-up calls.