Applying for SSI Before Leaving a Medicaid Nursing Home, Hospital, or Prison

If you are leaving a nursing home or hospital paid for by Medicare or Medicaid, or a jail or prison, you can apply for SSI before your release.

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You cannot receive disability benefits through Supplemental Security Income (SSI) if you live in a public institution such as a jail or prison. If you live in a Medicaid nursing home facility (one where Medicaid is paying for at least half of your stay) or a hospital or skilled nursing facility where Medicare is paying for the stay, your SSI benefit will be reduced to $30 per month. (Read our article on SSI for nursing home residents.)

If you believe you'll be entitled to SSI disability benefits on your release, you can use the Social Security Administration’s (SSA) “prerelease procedure” to apply for disability benefits several months before you expect to be released, which will help you get benefits faster once you leave the facility. If you are living in a nursing home or hospital, you can use the prerelease procedure to get a determination of the payment you can expect to receive on your release. Especially if you have been in an institution for a long time, it can be very helpful to know ahead of time how much SSI you can expect to receive when you are released.

To use the prerelease procedure, you must have a medical condition that is likely to meet the SSA’s disability criteria and you must apply within several months of your expected release date.

How Does the Prerelease Procedure Work?

The prerelease procedure lets the SSA accept applications from people who are still institutionalized and make faster decisions about their eligibility and make early determinations about how much money the beneficiary will receive if approved. This helps make transition into community life easier.

Sometimes institutions have prerelease agreements with the SSA. These agreements outline the responsibilities of both the SSA and the institution. However, your institution does not need to be in an agreement with the SSA for you to use the prerelease procedure.

The Prerelease Agreement

Prerelease agreements between the SSA and an institution can be either written on non-written. Either way, the agreement requires that the SSA help the facility’s employees learn how to use the prerelease procedure. The SSA must also give the facility a contact person at the SSA who will help with prerelease procedures.

Your institution’s general duties under a prerelease agreement

The prerelease agreement requires an institution to:

  • provide a liaison person to work with the SSA
  • tell the SSA if you are likely to be approved for SSI and could be released within 30 days of being approved
  • give the SSA your current medical evidence and any other nonmedical records or evidence that the SSA needs to process your application
  • let the SSA know when you are expected to be released and advise them of any issues that might result in a later release date, and
  • tell the SSA when you are released.

The SSA’s general duties under a prelease agreement

A prerelease agreement requires the SSA to:

  • process your disability claim or reinstatement as quickly as possible, and
  • let your facility know about the decision made in your claim (if you have given permission).

How Do I Apply for Disability While I am In a Public Institution?

The way you apply for benefits while in a pubic institution like a Medicaid nursing home or a prison depends on whether a prerelease agreement exists between your facility and the SSA.

If there is a prerelease agreement

To start the application process, you first need to let a staff member at your facility know you want to apply. The institution will then contact the SSA for you and advise the agency about whether your condition is likely to meet its requirements for approval. The SSA will work with the facility to gather your medical information for you. Your friends or relatives can also help you by letting the SSA know when your release is planned.

If there isn’t a prerelease agreement

If there isn’t a prerelease agreement, between your facility and the SSA, you will need to call the SSA to apply shortly before your release. Make sure to have your Social Security number ready when you call. The SSA will ,help you set up an appointment with your local SSA field office once you leave the facility. The SSA’s phone number is 800-772-1213.

How Long Will it Take To Get My Benefits Once I am Released?

The length of time it takes to get your benefits depends on your particular situation, but it can take as little as 30 days. Using the prerelease procedure will help you get them as quickly as possible.

If your benefits are simply being restarted, it will take less time. If your benefits were stopped for less than twelve months, they can be reinstated without a new disability application. If you were incarcerated for more than a year, getting a new decision from SSI could take several months.

If you are denied disability benefits after applying for SSI using the prerelease procedure, you will need to appeal the disability decision like anyone else.

by: , Contributing Author

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