The Clinical Guide to Supportive and Palliative Care for HIV/AIDS

A Clinical Guide to Supportive and Palliative Care for HIV/AIDS • Chapter 18: Legal and Financial Issues• Those under 24 must have paid sufficient taxes for at least six quarters during the3 years before becoming disabled.Once26determinedpicasto be eligible, an individual with HIV is entitled to monthly SSDIpayments until death or until the individual is no longer disabled. An individual’s monthlySSDI benefit can range from a couple of hundred dollars a month to over $1500 per month.Monthly SSDI benefit levels vary greatly depending upon Social Security contributions,age at the onset of disability and date of disability. A monthly benefit is also available forthe dependent spouse or children of an SSDI recipient.There is a 5-month waiting period for SSDI. Monthly disability payments begin at thestart of the 6 th month after the onset of disability. Upon applying for SSDI an individualmay be entitled to past due benefits if the SSA determines that the individual becamedisabled prior to application. Past due benefits are limited to up to 12 months.Receiving past due SSDI benefits can have an adverse impact on an individual’s SSI andMedicaid eligibility since both SSI and Medicaid are need-based programs with strictasset limits for eligibility. In such circumstances, consulting with a benefits expert orattorney is advised as steps can be taken to maximize a person’s ability to both retainassets and remain eligible for need-based programs.After a disabled person has received SSDI for 24 months, she is automatically entitled toMedicare coverage. The total Medicare waiting period for an SSDI recipient is 29 months,given the 5-month waiting period for SSDI benefits to begin. Depending upon her financialstatus, an individual may also be eligible for Medicaid.■ Supplemental Security Income (SSI)SSI is a need-based program that provides monthly benefits to individuals who are disabled,blind, or over 65 years old and who have limited income and assets. As with SSDI, oncedetermined to be eligible for SSI, an individual with HIV is entitled to monthly paymentsuntil death or until the individual is no longer disabled.For an individual living with HIV, in addition to the requirement that she must bepermanently and totally disabled as defined by the SSA, there are strict citizenship andimmigration status rules, and income and asset restrictions.In general, in order to be eligible to receive SSI payments an individual must be a U.S.citizen, a noncitizen who was receiving SSI on 8/22/96, or a lawfully present noncitizenwho entered the U.S. before 8/22/96.An individual cannot have more than $2000 in assets, excluding a home (if the individualresides there), and a car (if it is regularly used for transportation to medical appointments).If an individual is married and living with a spouse the asset limit is $3,000. The assetlimit is $5,000 for a disabled child living with two parents.Strict income limits also apply. To be eligible for SSI an individual’s monthly “countableincome” must be less than her SSI benefit level. Countable income over an individual’sSSI benefit level will result in ineligibility for SSI for each month in which the income isreceived. Not every dollar received or earned by a disabled individual is countable income.In general, countable income includes unearned income (i.e., interest and dividends)and the value of in-kind gifts and services, minus a $20 set-aside. It also includes earnedXVIIIU.S. Department of Health and Human Services • Health Resources and Services Administration • HIV/AIDS Bureau 367