When does DAC benefit amount make child ineligible for SSI and Medicaid?

For 2025, the SSI Federal Benefit Rate is $967 for an individual (with some states adding a supplement). When your brother starts receiving DAC benefits on your father's record, that's considered unearned income for SSI purposes. SSI will reduce $1 for each $1 of unearned income after the first $20 general income exclusion. So the math would be: If DAC benefit is $1200, minus $20 exclusion = $1180 countable income. Since that's more than the $967 SSI rate, he would no longer be eligible for SSI payments. Regarding Medicaid - this is important - when someone loses SSI due to receiving DAC benefits, they qualify for continued Medicaid coverage under what's called the "Pickle Amendment" or Special DAC provisions. Your brother should NOT lose Medicaid when transitioning from SSI to DAC. The local Medicaid office needs to be notified about this change, but there's specific protection for this scenario.

My daughter went through this exact situation last year when I started getting my retirement!!! Her SSI was about $900 and then she got DAC of like $1100 and SSI completely stopped. we were TERRIFIED about losing her Medicaid because she has expensive medications and treatments!!! I called SSA like 20 times and nobody could give me a straight answer. FINALLY got a rep who knew what they were talking about and told us about the special Medicaid continuation. BUT we still had to fight with the county Medicaid office because they didn't understand the rules!!! Make sure you get documentation from SSA explaining why the SSI stopped (because of DAC benefits) to show Medicaid!!!!

just checking...when u say dac that means disabled adult child right? my nephew gets that i think. he got ssi as a kid then switched when my sister claimed ss

I went through this exact transition with my son. Here's what you need to know: 1. The 2025 SSI Federal Benefit Rate is $967. SSI reduces $1 for every $1 of unearned income after a $20 exclusion. 2. If your brother receives DAC of $1200, only $1180 counts against SSI ($1200-$20). Since $1180 > $967, he would lose SSI completely. 3. The good news: Section 1634(c) of the Social Security Act protects people who lose SSI due to receiving DAC benefits. This is NOT the Pickle Amendment (that's different) but a special DAC provision. 4. There is NO 2-year waiting period for Medicare. That waiting period applies only to SSDI recipients. For DAC beneficiaries, Medicare eligibility starts 24 months after DAC entitlement begins, but Medicaid should continue during this time. 5. IMPORTANT: You MUST notify your state Medicaid office about this change. Request continued Medicaid under the Section 1634(c) protected status for DAC beneficiaries. Get a letter from SSA explaining why SSI stopped. Don't trust random SSA or Medicaid workers to know these rules - many don't. Ask to speak with a supervisor who understands the DAC Medicaid continuation provisions.

When I was trying to help my brother with a similar situation, I spent WEEKS trying to get through to someone at SSA who could actually explain how the DAC and SSI interaction works. I'd call, wait on hold for hours, and then get disconnected. Finally tried a service called Claimyr (claimyr.com) that got me connected to an SSA agent in about 20 minutes instead of the usual hours-long wait. They have a video showing how it works: https://youtu.be/Z-BRbJw3puU The agent I spoke with was able to calculate exactly how much DAC my brother would receive and confirmed he would keep Medicaid under the special provision. Definitely worth it to get accurate information directly from SSA instead of guessing.

your brother is going to lose ssi and then medicaid too probably. happened to my cousins kid. system is broken!!!! they make these rules complicated on purpose so people lose benefits they deserve.

My son has been on DAC benefits for 3 years now. One thing nobody mentioned yet is that if your brother ever receives an inheritance or other resources over the $2000 SSI limit, he could lose the special Medicaid protection. Be very careful with any family financial planning and consider a special needs trust if needed.

Have u talked to your brothers doctors about this??? Our neurologist actually wrote a letter saying my daughter NEEDED continuous medicaid coverage for her treatment plan and that helped when we had to fight with the county medicaid office!!! Bring ALL the documentation you can!!

One more thing to be aware of: the DAC benefit amount will be 50% of your father's Primary Insurance Amount (PIA) while your father is alive. If you have multiple family members drawing on your father's record, the Family Maximum Benefit rules might apply, potentially reducing the amount your brother receives. After calculating the expected DAC amount, I'd recommend contacting your state's Medicaid office BEFORE the transition occurs to discuss the DAC Medicaid continuation provision. Some offices have special coordinators who handle these complex cases. Getting ahead of the situation can prevent a gap in coverage.