Institutionalization affects your eligibility and your benefit rate. If you are a resident of a public institution for a full calendar month, you are not eligible for SSI unless one of the following exceptions applies:
The public institution is a medical treatment facility and Medicaid pays more than 50 percent of the cost of care. In the case of a child under age 18, Medicaid and/or private health insurance pays more than 50 percent of the cost of care;
You are living in a publicly operated community residence that serves no more than 16 residents. Such a facility must provide an alternative living arrangement to a large institution and be residential (i.e., not a correctional, educational, or medical facility);
The public institution is a public emergency shelter for the homeless. Such a facility provides food, a place to sleep, and some services to homeless individuals on a temporary basis. Payments to a resident of a public emergency shelter for the homeless are limited to no more than six months in any nine-month period;
You are in a public institution primarily to receive educational or vocational training. To qualify, the training must be an approved program and must be designed to prepare you for gainful employment;
You were eligible for SSI under one of the special work incentive provisions described in §§2178 and 2179 in the month before the first full month you live in a medical or psychiatric institution. The institution agrees to permit you to retain benefit payments. Payment may be made for the first full month of institutionalization and the next month; or
A physician certifies that:
Your stay in a medical facility is not likely to last more than three months; and
You need to continue to maintain and provide for the expenses of your home to which you may return.
Payments may be made for up to the first three full months of institutionalization.
In general, payment is limited to a maximum of $30 per month (minus any countable income) when:
You are a resident throughout a month in a public or private medical treatment institution; and
Medicaid pays over 50 percent of the cost of care for that month. In the case of a child under age 18, Medicaid and/or private health insurance pays more than 50 percent of the cost of care.
As with other benefits, States can supplement the $30 payment.
There are two exceptions to the maximum payment limit:
If you meet the requirements of (E) in 2121.1. above, you may receive full payment for the first two full months of institutionalization; or
If you meet the requirements of (F) in 2121.1. above, you may receive full payment for the first three full months of institutionalization.
The prerelease program helps institutionalized individuals return to community living. You may have completed your sentence in a correctional facility or are ready to be released from a medical institution, but cannot financially support yourself. The prerelease program allows you to apply for SSI payments and food stamps several months before your anticipated release so your benefits can begin quickly after you leave the institution.
A formal prerelease agreement can be developed between an institution and the local Social Security office. However, you can file an application for SSI under the prerelease procedures even if your institution does not have a formal agreement.
Last Revised: Jul. 17, 2007
