Tag: public benefits

ABLE: An Account to Overcome the SSI Resource Limit for Adults with Disabilities

Posted on by Nicol Walsh

Living with a disability can be challenging, especially with financial limitations. The Stephen Beck Jr. ABLE Act of 2014 allows individuals with disabilities to save up to $20,000 annually without losing their benefits. These ABLE accounts can be used for various Qualified Disability Expenses, such as housing, education, and health. Learn more about how ABLE accounts can help improve your quality of life and financial independence.

A Brief Overview

  • The Stephen Beck Jr. ABLE (Achieving a Better Life Experience) Act of 2014 allows individuals to save up to $20,000 annually without affecting their public benefits.
  • An account holder may save up to $100,000, bypassing the $2,000 resource limit for Supplemental Security Income (SSI), Medicaid, and other public benefits programs.
  • Funds may be used for qualified disability expenses (QDEs) that improve or maintain the account holder’s health, independence, and/or quality of life.
  • ABLE accounts are savings accounts and the account holder may choose to distribute a percentage of the funds to investments, including stocks, bonds, and mutual funds.
  • Forty-five states and the District of Columbia have ABLE Savings Plans with some states accepting out-of-state enrollment.
  • Washington State ABLE Savings Plan began in 2018, following Oregon ABLE Savings Plan, so some Washingtonians signed up early through that option or through the national ABLE For ALL Savings Plan.
  • PAVE provides a Qualified Disability Expense (QDE) Tracking Form, available in multiple languages.

Introduction

Living with a disability can be difficult and costly. Adults who receive benefits from the Social Security Administration because of disability often are challenged to improve their life circumstances because of a $2,000 resource limit. This limit means that a person receiving payments from Supplemental Security Income (SSI) or the Social Security Disability Insurance (SSDI) program cannot have a bank account balance or any other resources on hand that exceed $2,000, without losing part of their benefit.

Savings of $2,000 or less can be limiting for someone who might want to move into a new home, invest in a vehicle or save for higher education or a vocational training program.

What is the Able Act?

The government provides a way for individuals with disabilities to overcome this barrier and save money. The Stephen Beck Jr. ABLE (Achieving a Better Life Experience) Act of 2014 allows individuals to save up to $20,000 annually without losing benefits. ABLE is modeled after college savings plans. The savings and/or investment account bypasses the SSI resource limit and can grow interest tax-free.

There are some restrictions:

  • The account holder must meet criteria for a disability that began before age 46.
  • The account may not receive more than $20,000 per year.
  • If the account balance exceeds $100,000, Social Security benefits are impacted but Medicaid benefits will remain in place.
  • Most accounts have a total lifetime balance limit of $500,000.

Beginning January 1, 2026, the age criteria increased from 26 to 46 years of age. Under this expansion, many adults who were previously not eligible because their disability began after age 26 will now qualify to open an ABLE account for the first time. This adjustment is significant because thousands of people who became disabled in young or mid‑adulthood, including through injury, illness, or newly diagnosed conditions, will gain access to a savings option that protects their eligibility for public benefits

How can money In an ABLE account be used?

ABLE account money may not be spent on just anything. Generally, the funds can be used to pay for expenses that may help improve or maintain health, independence and/or quality of life. These are called Qualified Disability Expenses (QDEs). In this webinar recording, presented by ABLE National Resource Center, the ABLE expert presenters noted that “QDEs should be broadly understood and should not be limited to expenses for which there is a medical necessity or expenses that provide no benefits to others (outside of the benefit to the beneficiary).”

Here are a few examples of qualifying expenses: 

  • Housing
  • Education
  • Transportation
  • Personal support services
  • Assistive technology
  • Health and wellness
  • Employment training and support

ABLE accounts are subject to IRS or SSI audits, so the account holder should keep a record of how money has been used, including:

  • the purpose or cause of the expense
  • how the expense relates to improving or maintaining health, independence, and/or quality of life
  • a copy of the proof of purchase or payment

Qualified Disability Expense Tracking Form

PAVE has created a QDE Tracking Form to make it easier to keep track of your ABLE account activity.

Download the Qualified Disability Expense Tracking Form:
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What type of financial account is ABLE?

The ABLE account is a savings account, insured by the Federal Deposit Insurance Corporation (FDIC). A chosen percentage of funds in the account may also be allocated as uninsured investment money. The account holder can choose a low-, median-, or high-risk investment strategy. Low-risk is the safest, most conservative option, with the lowest possibility for return. A high-risk investment might make more money but also could lose more. A median-risk investment is somewhere in between. Based on the account holder’s choice, the money is automatically allocated into some combination of stocks, bonds, and mutual funds.

An individual considering these options may want to consider how long the money will be in the market and risk tolerance. ABLE does warn that invested money is not insured and that money, including principle, may be lost over the course of an investment period.

The account holder, family and friends can deposit funds into the account using post-taxed dollars. Contributions are not federally tax deductible; however, some states may allow for state income-tax deductions for contributions made to an ABLE account.

Where are ABLE programs available and open for enrollment?

Although the program was federally enacted, ABLE is state-run. Washington’s program opened for enrollments in July 2018. So far, enrollments have been low, with the State Department of Commerce reporting that only a few hundred people have opened accounts. Commerce estimates about 30,000-50,000 people in Washington are eligible for the ABLE Savings Plan and have the financial assets to open an account.

Forty-five states and the District of Columbia have ABLE Savings Plans. Oregon’s plan was a year and a half ahead of Washington’s, so some Washingtonians signed up early through that option or through the national ABLE For ALL Savings Plan.

Individuals can shop around for the best program to meet their needs, and some states accept clients from all 50 states, including Virginia, Ohio, Nebraska, and Tennessee. Virginia is among the few states that issue a debit card for the account. The ABLE National Resource Center provides tools for reviewing the various state programs to find the best fit. Washington State ABLE Savings Plan links directly to a clickable form to determine eligibility.

Learn More

Dial 711 for Telephone Relay Service (TRS) or teletypewriter (TTY), or call:

Additional Resources:

Medicaid or Medicare-Which Covers Long-Term Care?

Posted on by Barb Koumjian

This quick tip sheet explains which of these programs covers long-term care either in your home, or in a nursing home or other care facility.

Medicare:  No long-term care coverage in the home or in a care facility

  • The Medicare Part A benefit for medically necessary skilled nursing facility care becomes active after hospital treatment for an illness or injury.   
  • Medicare Part A pays for medically necessary skilled nursing facility care, up to 100 days, if the patient is actively participating in rehabilitation services and showing improvement within their plan of care.
  • Medicare Part A does not pay for ongoing long-term (custodial) care in a skilled nursing facility once rehabilitation is complete, nor does Part A pay for ongoing long-term (custodial) care in assisted living, memory care, or adult family homes. 
  • Medicare Part B pays for medically necessary home health care, if the patient is homebound, actively participating in rehabilitation services (physical therapy, occupational therapy, respiratory therapy) and showing improvement within their plan of care.

Medicaid:  Long-term care coverage is available in the home and in certain care facilities.

  • Eligibility is based upon the income, resources, and functional need of the applicant.
  • There are special allowances for income, resources, and housing costs of married couples.
  • Medicaid can pay for in-home care or residential care in certain facilities that accept Medicaid funding to pay for the long-term (custodial care) of their residents.
  • Recipients may be required to pay “financial participation” to their care provider, to qualify for and to maintain their Medicaid eligibility, depending upon their income level. 
  • Estate recovery is required to return Medicaid funds to the state once a Medicaid recipient or the surviving spouse of a Medicaid recipient dies.
  • There is a five-year “lookback period” to determine whether an applicant had been “gifting away” resources to qualify for Medicaid. 
  • Eligibility for a recipient receiving Medicaid is reviewed every twelve months. 

Courtesy of Pierce County Washington’s Aging and Disability Resource Center (ADRC), part of the Aging and Disability Resource Centers network across WA State. Find your area’s ADRC at Community Living Connections.

Disability Redetermination: What Happens to Supplemental Security Income (SSI) When a Child Turns 18?

Posted on by Nicol Walsh

A Brief Overview

  • When a child turns 18 years of age, SSA conducts a redetermination for eligibility based on the same eligibility criteria as new adult applicants.
  • A young adult who no longer meets the eligibility for blind or disabled may continue to receive SSI payments if they qualify for Section 301 status.
  • If the dependent child of a service member on active-duty orders overseas is receiving SSI, the benefits will stop when they turn 18 years of age unless and until they have established residency in the United States for thirty (30) consecutive days.

Full Article

As a continuation to our article, Supplemental Security Income (SSI) is a monthly financial benefit from the Social Security Administration (SSA) to eligible children and adults. The SSA’s definitions of blind and disabled are the same for both adults and children, although there are some differences in eligibility requirements. 

Definitions Of Blind and Disabled

SSA defines “blind” as seeing at a level of 20/200 or less in the better eye with glasses or contacts, or having a limited field of vision that can only see things at within a 20-degree angle or less in the better eye.  A person with a visual impairment that does not meet the criteria for blindness may still qualify for SSI based on the disability.

An adult or child may qualify for SSI as “disabled” if they have a physical or mental impairment that can be medically diagnosed through clinical and laboratory diagnostic techniques for anatomical, physiological, and psychological irregularities. The condition must cause marked and severe functional limitations, including emotional or learning challenges, that have lasted or are supposed to last for at least 12 months without interruption.

What Happens When a Child Turns 18?

If a child is receiving SSI benefits, SSA will review their case two (2) months prior to the child turning 18 years of age to determine if the current medical condition(s) meets the disability requirements as an adult.  SSA will use the same criteria as new adult SSI applicants to determine if the child will qualify for disability benefits upon becoming a young adult at age 18.  This process is called redetermination.

Next, SSA will interview the young adult at the local SSI field office or by phone. SSA will ask about the young adult’s income and resources, past and current employment, and their current living arrangements. If the Adult Disability Report (SSA-3368) and Authorization to Disclose Information to SSA (SSA-827) were not completed beforehand, the SSA representative will assist the young adult in completing the forms during the interview.

Then, SSA will send the case to the DDS to review all medical information and determine if the impairments meet the SSA’s adult definition of disability. The DDS will consider all current impairments, including any new impairments even if they do not meet the duration requirement, and order consultative exams if necessary.

Finally, the young adult will receive a written notice of decision from the SSA. If the decision is that the young adult meets the adult criteria, benefits will continue uninterrupted.  If the decision is that the young adult does not meet the adult criteria, the young adult is no longer eligible for SSI, and benefits will cease after a two (2)-month grace period. Benefits may continue if the young adult appeals the decision or is granted Section 301 status.

Generally, it is easier for a child to become eligible for SSI than to wait until they turn 18 because the child is not required to show inability to obtain substantial gainful activity.

An individual is considered an adult at the age of 18, even when they are not considered competent.

What Is Section 301 Status?

A young adult who has been deemed ineligible for SSI at age 18 redetermination may continue to receive benefits if they are participating in an approved special education or vocational rehabilitation program. When benefits continue under this program it is referred to as Section 301 status. Approved programs include:

  • Individualized Education Program (IEP) for a young adult aged 18 through 21
  • Employment plan through a Vocational Rehabilitation agency
  • An approved Plan to Achieve Self Support (PASS)
  • A written service plan with a school under Section 504 of the Rehabilitation Act

If the young adult’s physical or mental impairment has ceased, their SSI benefits will not be terminated or suspended if:

  • The young adult participates in an appropriate program of Vocational Rehabilitation (VR) services, employment services, or other support services.
  • They began participating in the program before the month his or her disability or blindness ceased.
  • They continue to participate in the program through the two (2)-month grace period after cessation; and
  • Completion of the program, or continuation in the program for a specified period of time, will increase the likelihood that the young adult will not return to the disability or blindness benefit, as determined by the SSA.

If benefits stop at age 18, the young adult has a right to appeal the decision through reconsideration or appeal to administrative law judge.  If the appeal is filed within 10 days of the redetermination notice, SSI payments will continue while the appeal is in process.

If The Child Was Receiving SSI as a Military Dependent Overseas

The special rule that allows dependent children of active duty servicemembers serving on permanent duty ashore to an overseas assignment does not apply after the child turns 18 years of age. Once the child turns 18, they will no longer be eligible for SSI until they have been living within the United States for thirty (30) consecutive days. The SSA requires proof of residence stateside, which may include a utility bill or rental agreement.  If the young adult was not paying room and board from the date residency began, the period during which they were not charged will be considered in-kind income and may delay a positive eligibility determination.

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