Are you risking your, your family members, or your client's government benefits?

If you see Red or Yellow, SLOW DOWN. Book a no-cost consultation with CPT Institute.

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Means-Tested Benefits
(Needs Based)

Resource and Income test required for eligibility

Includes

  • Supplemental Security Income (SSI)
  • Traditional Medicaid (Medi-cal in CA) - disabled and unable to earn gainful employment
  • Housing Voucher (HUD, Section 8)
  • Social Security Disability Income (SSDI) who receive less than the Supplemental Security Income (SSI) rate.
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Income-Based Benefits

Has an income test for eligibility. NO ASSET TEST!

Includes

  • Expanded Medicaid - low income and are able to earn gainful employment
  • VA Benefits

If your client has the following, no consultation needed.

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Entitlement Benefits

Generally not affected by a settlement (excluding the state offset, when applicable)

Includes

  • Social Security Disability Insurance (SSDI) - only if the amount is greater than the Fed SSI rate
  • Social Security Retirement
  • Social Security Survivor Benefits
  • Medicare (excluding MSP compliance)

*CAUTION: Low wage earners with SSDI may be have SSI which makes them eligible for state Medicaid in most states

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Disability "Means-Tested" Benefits (often Needs - Based)
= Income, Assets, and Resources Rules apply

Disability Benefits "Means-tested" refers to benefits that would be lost by accepting a settlement due to state- imposed income and resource limits. The most common of these benefits are Medicaid, In Home Support Services (IHSS), and long-term care services. It is often the only form of health insurance available to those with limited taxable work history.

Income - Based Benefits
= Only Income Rules Apply

The cost of these benefits may be increased by accepting a settlement, but they are not typically lost. Eligibility will be based on household MAGI income. At age 65, clients on income-based Medicaid switch to means-tested/traditional. Those with Medicaid Set-Aside not held in trust can jeopardize their Medicaid eligibility.

Entitlement Benefits
= No Income or Asset Rules Apply

These benefits represent that they have been prepaid through taxes in work history. They are generally not affected by a settlement (excluding the state offset, when applicable.)

Visit cptinstitute.org to read our blog titled "Medicaid Underestimated Value to Medicare Recipient" to learn more.

Disclaimer: This resource provided by CPT Institute is for informational purposes only and are intended to be used as a non-legal guide prior to consultation with an attorney familiar with your specific legal situation. CPT Institute is not engaged in the practice of law or in rendering legal advice or counsel. No such legal advice or counseling is either expressly or impliedly intended. If you require legal advice, you should seek the services of an attorney.