Many people who receive Supplemental Security Income (SSI) disability benefits will need to receive care in a nursing home at some point in their lives. But if you think that nursing home care is just for the elderly, you're wrong. An SSI recipient who uses nursing home care could be a disabled child recuperating from surgery in a nursing home or an injured young adult who needs life-long, round-the-clock care.
Whatever their age, when individual SSI recipients live in nursing homes, the amount of SSI that they receive each month is affected. The type of facility they live in and the length of their stay will determine how much SSI individuals can keep.
In a nutshell, if you move to a nursing home where Medicaid pays for part of your stay, your SSI benefit will stop or be lowered. On the other hand, if you pay for a private facility or rest home, your state may supplement your SSI payment.
The amount of SSI that you can receive while living in a nursing home depends on whether Medicaid is paying for more than half of your cost of care. (Learn when your state's Medicaid program will pay for a nursing home.)
Here are some situations where you will and won't receive SSI while living in a nursing home.
If you're in a nursing home and Medicaid is paying more than half the cost of your care, you're eligible for only a small, reduced SSI benefit. Your SSI benefit will be reduced to $30/month for individuals or $60/month for a married couple who both receive SSI. You'll only receive the reduced payment if the nursing facility is one that can provide inpatient medical services (Medicaid won't pay for non-medical facilities like an assisted living facility).
Some states supplement this amount and allow you to keep more of the amount. (See more about state supplements below.)
If you live in a public medical facility where Medicaid does not pay for more than half of your care, then you're not eligible for any SSI benefit.
If you're living in a private care facility that doesn't accept Medicaid, then you can keep your SSI, although, of course, you might not be eligible for SSI if you have enough income to afford private care. But some states supplement SSI with state supplemental payments that can pay a good portion of the cost of a private facility.
If both you and your spouse receive SSI, you will continue to receive SSI if your spouse enters a nursing home. Instead of receiving the couple rate of $1,371/month, you will start to receive the individual rate of $914/month.
The rules for children who receive SSI are more generous: children are eligible for the $30 reduced payment if they live in any nursing home, whether Medicaid or private insurance pays for more than half the cost of care.
Most states give additional money to SSI recipients in the form of a supplement to the federal monthly SSI payment. For example, California pays a $59 supplement to SSI recipients who live in Medicaid-paid nursing homes and are eligible for the reduced federal $30/month SSI payment. Massachusetts adds a $42.80 supplement to the $30 reduced federal SSI amount.
Some states pay a higher state supplement to SSI recipients who live in nursing homes that aren't paid for by Medicaid. For instance, California adds an extra $579 per month to individuals living in a non-medical out-of-home care facility to supplement the federal SSI payment, for a monthly total of $1,493. Massachusetts adds $293 per month, for a monthly total of $1,207.
As mentioned above, Medicaid doesn't typically pay for room and board costs at a non-medical facility like an assisted living facility. But because the monthly SSI amount is not enough to afford the typical cost of an assisted living facility, many states have separate programs through which they supplement the SSI payments of people in non-medical long-term care facilities. For example, Massachusetts pays an extra $454 per month to SSI recipients living in assisted living facilities, for a total of $1,368.
In some states, the SSI state supplement is paid directly to the facility.
If you're only going to be in a nursing home for a short time, you can keep your full SSI payment if your doctor tells the Social Security Administration (SSA) in writing that you will be there 90 days or less and you tell the SSA that you need your SSI to preserve your permanent housing. Social Security calls this benefit a "temporary institutionalization" benefit.
Temporary institutionalization benefits are available to adults in Medicaid-certified nursing homes or public hospitals or institutions, and to children in any type of facility, including a private medical facility.
SSI recipients must notify Social Security when they enter a nursing home. Usually, nursing home staff will help the SSI recipient notify Social Security, particularly if the nursing home will be billing Medicaid for its services. Nursing home staff are usually good sources of information about Medicaid and Social Security benefits for residents.
SSI recipients who have questions about their benefits can also contact their state's Medicaid agency. You can locate your state's Medicaid agency at Medicaid.gov.
If your SSI has been terminated and you disagree with the decision, consult a disability lawyer.
If you're leaving a nursing home, ask the nursing home staff about SSI's "prerelease procedures" so can get your full SSI benefit back as soon as you get home. Some long-term care facilities have an agreement with the Social Security Administration providing for pre-release applications.
Several months before you expect to leave the nursing home, let a staff member at your facility know you want to re-apply for SSI benefits. The institution should then contact the SSA for you and advise the agency about whether your condition is likely to meet its requirements for approval for disability benefits. The SSA will work with the facility to gather your medical information for you. Starting ahead of time will help you get benefits faster once you leave the nursing home.
If your nursing home doesn't have a prerelease agreement with the SSA, you'll need to call the SSA to apply. The SSA will help you set up an appointment with your local SSA field office for after you've left the nursing home. The SSA's phone number is 800-772-1213.
Updated July 31, 2023
Supplemental Security Income (SSI) in California 2023 (Social Security).
Massachusetts State Supplement CY 2023 Payment Levels (Massachusetts Department of Transitional Assistance).