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Effective: May 1, 2009 |
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04.35ar2 - Referrals for Social Security Benefits (Archive) |
Archived: November 1, 2011 |
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.
Note: See Referrals to Medicare for information on referring clients to apply for Medicare.
Clients can contact the Social Security Administration (SSA) to find out how to apply by:
l Calling (800) 772-1213.
l Checking the Social Security Web site - www.ssa.gov.
When to Refer for Social Security Benefits.
Referring Noncitizens for SSI.
Steps for a Social Security Referral.
Social Security Referral - Good Cause.
When to Refer for Social Security Benefits
Refer the following enrollees to apply for Social Security if not currently receiving RSDI, SSI, or both and he or she:
l Is age 66 or older, or two months before the enrollee's 66th birthday and has sufficient quarters of coverage for insured status under the Social Security program. This applies to people with birth years from 1943 through 1954.
l Was born before 1943, has insured status, and has not yet applied for Social Security retirement benefits.
l Is age 65 or older, not receiving a Social Security retirement benefit, and income is lower than the SSI income standard.
l Is age 65 or older and receiving a Social Security retirement benefit that is less than the SSI income standard.
l Is under age 65 and reports:
n a disability that is expected to last one year or more, or
n blindness.
Note: Clients whose referral to SSA is based on a disability must also be referred to the State Medical Review Team (SMRT).
l Is a spouse, age 66 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 the retired or disabled worker’s child who is under age 16 or disabled.
n The child is receiving social security benefits.
l Is a 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 if attending elementary or secondary school full time, and meets both of the following:
n Is unmarried.
n One or both of his or her 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 all of the following:
n Is at least age 50 but not older than age 60.
n Is disabled.
n Is not currently married unless the widow or widower was already disabled and then remarried after age 50.
l Is a widow or widower who meets both of the following:
n Is age 60 or older.
n Is not currently married unless he or she remarried after age 60.
l Is a parent with a deceased adult child, and the parent was dependent on the child for at least half of their support.
l Is an ex-spouse and meets all of the following:
n was married to the ex-spouse at least 10 years.
n is age 66 or older.
n is not married.
Note: The client may be entitled to benefits under the ex-spouse’s record whether the ex-spouse is still working, or is retired or disabled if the benefits are equal to or higher than benefits under the client’s own record.
l Is an ex-spouse who meets both of the following:
n Is not currently 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 former spouse is deceased.
n The marriage lasted at least 10 years.
n Is age 60 or older.
n Is not currently married unless the remarriage occurred after age 60.
l Is an ex-spouse and meets all of the following:
n The former spouse is deceased.
n The marriage lasted at least 10 years.
n Is age 50 or older.
n Is disabled.
n Is not currently married unless the ex-spouse was already disabled and then remarried after age 50.
Note: A person can only receive benefits under another person’s Social Security number if that person has at least 40 work credits under Social Security.
Do not refer nonqualified noncitizens for SSI.
Refer qualified noncitizens for SSI who:
l Were living in the United States prior to August 22, 1996, and:
n received SSI on August 22, 1996.
n continue to be elderly or disabled.
l Were living in the United States prior to August 22, 1996, but:
n did not receive SSI on August 22, 1996.
n is disabled.
l Came to the United States after August 22, 1996, and meet one of the following:
n Were granted refugee, asylee or withholding status within the past seven years.
Note: Refugees include, but are not limited to, Cuban/Haitian entrants and Amerasian immigrants.
n Are U.S. veterans, active duty military personnel, the spouse of a U.S. veteran or active duty military personnel, or the unmarried child of a U.S. veteran or active duty military personnel.
n Have been in the United States or adjusted status for five years and have worked 40 quarters.
n Are Victims of Trafficking.
n Are qualified American Indians.
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: Also follow these steps for an applicant age 18 or older, 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 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 the next available month giving 10-day notice for the following caretakers who live in the same household as the child and who fail to apply for Social Security for the child.
n Biological/Adoptive parent.
n Relative caretaker with legal custody.
n 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. The county determines whether the client has established good cause.
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.
Note: Clients who are eligible for the buy-in do not have to wait until open enrollment.
Good cause can be established for a specified or indefinite period, or it can excuse a client from applying for Social Security.
For more information see: