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Effective: December 1, 2006 |
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04.35ar1 - Referrals to Social Security Benefits (Archive) |
Archived: May 1, 2009 |
Certain clients eligible for Minnesota Health Care Programs (MHCP) must apply for Social Security benefits if it appears they might be eligible for those benefits. This section provides policy on when and how to refer a client to apply for Social Security.
Clients can contact Social Security Administration (SSA) to find out how to apply by:
l Calling 1-800-772-1213.
l Checking the Social Security website - www.ssa.gov.
When to Refer to Social Security Benefits.
Steps for a Social Security Referral.
Social Security Referral – Good Cause.
When to Refer to Social Security Benefits
Refer the following enrollees to apply for Social Security, if the client is not currently receiving RSDI and/or SSI, and the client:
l Is age 65 or older, or two months before the enrollee's 65th birthday.
l Reports a disability or blindness condition that is expected to last one year or more.
Note: Client’s whose referral to SSA is based on a disability should also be referred to the State Medical Review Team (SMRT).
A dependent can only receive benefits under another person’s SSN if that person has at least 40 work credits under Social Security.
l Is a spouse, age 65 or older, of a retired or disabled worker.
l Is a spouse, of any age, of a retired or disabled worker and meets both of the following:
n The spouse is caring for worker’s child who is under age 16 or disabled.
n The child is receiving social security benefits.
l Is a severely disabled child age 18 or older and meets all of the following:
n The disability must have begun before age 22.
n The child’s parent could be disabled, retired or deceased.
l Is a child under age 18, or up to age 19, and meets the following:
n Is unmarried.
n Is attending elementary or secondary school full time.
n One or both of his/hers parents are disabled, retired or deceased.
l Is a widow or widower of any age who meets one of the following:
n Is caring for a child who is under age 16 or disabled.
n The child is receiving social security benefits.
l Is a widow or widower who meets both of the following:
n Is age 50 or older.
n Is disabled.
l Is a parent with a deceased child, and the parent was dependent on their child for at least half of their support.
l Is an ex-spouse and meets all of the following:
n The marriage lasted at least 10 years.
n The client is age 65 or older.
n The client is not married.
n The client is not entitled to equal or higher benefits on their own or another’s record.
Note: The client can apply whether the ex-spouse is still working, retired or disabled.
l Is an ex-spouse who meets all of the following:
n Is not married.
n Is caring for a child eligible on the deceased parent’s Social Security record.
l Is an ex-spouse and meets all of the following:
n The marriage lasted at least 10 years.
n Is age 60 or older.
n Not currently married unless the remarriage occurred after age 60.
l Is an ex-spouse and meets all of the following:
n The marriage lasted at least 10 years.
n Is age 50 or older.
n Is disabled.
n Is not currently married unless the remarriage occurred after age 50.
Noncitizens must be qualified noncitizens in order to be eligible for SSI.
Note: Noncitizens who are in an immigration class that does not qualify for federally funded programs should not be referred for SSI.
Eligibility for SSI is more restrictive than MHCP. Qualified noncitizens must also meet one of the following to be referred to Social Security:
l Be an LPR who may be credited with 40 quarters of coverage under Social Security.
l Be a qualified American Indian.
l Meet the military exception.
l Be a noncitizen residing in the U.S. who were receiving SSI benefits on 8/22/96.
Certain qualified noncitizens may be eligible for SSI for a period of seven years after they attain their immigration class, if they do not meet the above criteria. This group should be referred to Social Security and includes:
l Refugees.
l Asylees.
l Persons granted withholding of deportation.
l Cuban/Haitian entrants.
l Amerasian immigrants.
Steps for a Social Security Referral
Once it is determined that a client must be referred to Social Security, follow these steps to refer an enrollee to apply for Social Security benefits.
Note: These steps should also be followed for an applicant 18 and over, or for the caretaker of an applicant under age 18, who was previously referred to Social Security as an MHCP enrollee but did not apply, and is not currently receiving RSDI and/or SSI. Do not approve eligibility until confirmation of the application to Social Security is received.
1. Send the client a referral to apply for Social Security benefits.
Note: Clients have 60 days from the date referred to apply for Social Security and provide proof of application.
2. Complete the following for clients who do not comply with application for Social Security unless there is good cause:
l Clients under age 18:
Close MHCP eligibility for certain caretakers who live in the same household as the child and who fail to apply for Social Security for the child.
n Close for the next available month giving 10-day notice.
n Close eligibility for the following caretakers:
m Biological/Adoptive parent.
m Relative caretaker with legal custody.
m Legal guardian.
l Clients age 18 and over: Close MHCP eligibility for the client who fails to apply for Social Security the next available month giving 10-day notice.
Social Security Referral – Good Cause
Clients may establish good cause for not complying with a referral to apply for Social Security benefits.
Good cause means there were circumstances beyond the client’s control or that the client could not reasonably foresee which prevents or prevented the client from applying for Social Security. It is established on a case by case basis.
Good cause circumstances include but are not limited to:
l An illness which prevents the client from applying.
l An incapacity preventing the client who has no legal representative from applying.
l The client previously applied, was denied and reasons for denial have not changed.
l The client cannot apply until open enrollment.
Good cause can be established for a specified or indefinite period of time, or it can excuse a client from applying for Social Security.
For more information see: