How Much Does a Child With Autism Get From SSI?

July 2, 2024

Discover how much a child with autism gets from SSI and other crucial financial support options.

SSI Benefits for Children with Autism

Supplemental Security Income (SSI) offers financial aid to children with autism, providing them with the necessary support needed for their care. Understanding how this program works and the factors affecting the SSI amounts is crucial for families seeking this assistance.

Understanding Supplemental Security Income

Supplemental Security Income (SSI) is a federal program designed to assist people with disabilities, including children with autism. It aims to provide a basic income to families that meet specific income and resource requirements. A child with a disability may be eligible for SSI benefits until the age of 18. After they turn 18, impairments are evaluated based on the definition of disability for adults [1].

In 2023, the maximum monthly benefit for SSI is $914 per individual. However, the amount a child with autism can receive from SSI depends on various factors [2].

Most states also offer Medicaid to children receiving SSI benefits, assisting with medical bills. Children under 18 who require institutional-level care and live at home may maintain Medicaid eligibility while receiving home care if it is more cost-effective for the government.

Factors Affecting SSI Amounts

The amount of SSI or SSDI benefits received by a child with autism depends on several factors. These factors include the severity of the child's condition, the family's income and resources, and the state in which the family lives. Each state has its own guidelines for payout amounts, qualifying resources, and acceptance criteria [3].

Another important factor is the child's living arrangement. For instance, deeming from the parent stops when a child turns 18, marries, or no longer lives with a parent. In such cases, the child may receive up to $30 plus the applicable State supplement under certain conditions, such as being in a medical treatment facility and eligible for Medicaid under a State home care plan.

In summary, the SSI benefits for a child with autism can vary significantly based on an array of factors. It's essential for families to understand these factors and how they apply to their specific situation to navigate this process effectively.

Eligibility for SSI

Understanding the eligibility criteria for Supplemental Security Income (SSI) can significantly help parents of children with autism navigate the financial landscape. Here we discuss SSI benefits for children and how these benefits change when a child turns 18.

SSI Benefits for Children

A child with a disability, including autism, may be eligible for Supplemental Security Income (SSI) benefits until the age of 18 [1]. The amount a child with autism can receive from SSI depends on various factors, including the severity of their condition and the state they reside in. Each state has its own guidelines for payout amounts, qualifying resources, and acceptance criteria, which can affect the amount of SSI or SSDI benefits received by a child with autism. As of 2023, the maximum monthly benefit for SSI is $914 per individual.

In most states, a child receiving SSI benefits can also receive Medicaid to assist with medical bills. Notably, children under 18 who require institutional-level care and live at home may maintain Medicaid eligibility while receiving home care if it is more cost-effective for the government.

Changes in SSI Benefits at Age 18

When a child receiving SSI benefits turns 18, their impairments are evaluated based on the definition of disability for adults, which may result in changes to their SSI benefits. Additionally, financial assistance from a parent, known as "deeming," stops when a child turns 18, marries, or no longer lives with a parent. In such cases, the child may receive up to $30 plus the applicable State supplement under certain conditions, such as being in a medical treatment facility and eligible for Medicaid under a State home care plan.

Understanding these changes is crucial for families to effectively plan for their child's financial future and continue supporting their child's needs.

Medicaid and SSI

Navigating the financial aspects of caring for a child with autism can be challenging. However, the good news is that there are several programs designed to offset some of these costs. For instance, a child receiving Supplemental Security Income (SSI) benefits can also qualify for Medicaid in most states. This section will explore the coverage Medicaid offers and its eligibility criteria.

Medicaid Coverage for SSI Recipients

Medicaid is a federal and state program that helps with medical costs for some people with limited income and resources. For children receiving SSI benefits, Medicaid can provide much-needed relief by covering a wide range of medical bills. Children under 18 who need institutional-level care but live at home can maintain Medicaid eligibility while receiving home care, provided it is more cost-effective for the government [1].

In addition to the basic medical coverage, Medicaid Waivers are available in most states to provide additional support services. These are aptly designed for individuals with developmental disabilities, allowing them to remain at home or in their community. The benefits offered by these waiver programs vary by state but generally include coverage for medical treatments, respite care, transportation, in-home support, and more.

Medicaid Eligibility Criteria

Medicaid eligibility is primarily determined by income level and need. Children who qualify for SSI benefits are often eligible for Medicaid. However, each state has its own rules about who is eligible and what is covered. Therefore, it's crucial to understand the specific criteria in your state.

Moreover, children who qualify for waiver services under the Home- and Community-Based Services (HCBS) program may also qualify for medical assistance or other public insurance. This can provide additional support for their healthcare needs, further easing the financial burden on families.

To sum up, Medicaid, alongside SSI, can significantly aid in managing the financial aspects associated with caregiving for a child with autism. It's important to fully understand these resources and how to access them to ensure the child receives the necessary support and care.

Other Financial Support Options

While understanding the SSI amount for a child with autism is crucial, it's also important to consider other financial support options available for children with disabilities.

Social Security Disability Insurance (SSDI)

Social Security Disability Insurance (SSDI) is a financial benefit available for adults who have a disability that began before they turned 22. This benefit is considered a “child’s” benefit because it is paid based on a parent’s Social Security earnings record [4].

The SSDI disabled adult “child” benefits continue as long as the individual remains disabled. Notably, the child does not need to have worked to receive these benefits.

ABLE Accounts for Individuals with Disabilities

ABLE Accounts, established through the Achieving a Better Life Experience (ABLE) Act of 2014, provide another savings option for families of individuals with disabilities. These accounts allow families to save for the long-term expenses associated with their child's disability without sacrificing eligibility for public benefits such as Medicaid and Supplemental Security Income (SSI) [4].

ABLE accounts can be used to cover expenses related to the individual's disability, as long as they are for approved categories like education, health and wellness, housing, transportation, legal fees, and more.

While the exact benefits of SSDI and ABLE accounts will vary depending on the specifics of the individual's situation, both programs offer important financial support for families navigating the financial challenges associated with autism. Understanding these options is a critical part of financial planning for families supporting a child with autism.

Community Support Programs

In addition to financial assistance through SSI, there are community support programs in place to help families with children diagnosed with Autism Spectrum Disorder (ASD). Two such programs are the Home- and Community-Based Services (HCBS) Waiver Program and Medical Assistance for Children with Autism.

Home- and Community-Based Services (HCBS) Waiver Program

The Home- and Community-Based Services (HCBS) waiver program is the most common type of financial support for families with children with disabilities, including ASD. This program provides support services and care for individuals with developmental disabilities to allow them to remain at home or in the community. The benefits provided by these waiver programs vary by state but generally include coverage for medical treatments, respite care, transportation, in-home support, and more.

The funding from an HCBS waiver is determined by the child's disability level and its impact on the family. This support may be available regardless of income, with different income criteria for children/teens under 18 and young adults 18 or older. However, there are often long waiting lists for these services, and parents are advised to contact their local HCBS office promptly after their child is diagnosed with ASD to get on the waiting list.

Medical Assistance for Children with Autism

Children who qualify for waiver services under the HCBS program may also qualify for medical assistance or other public insurance, providing additional support for their healthcare needs.

Families are advised to contact their state or county offices of the departments of health and human services, mental health, or state developmental disabilities organizations to understand the specific services available in their state for children with autism spectrum disorder (ASD). Various organizations and programs at the local and state levels can provide valuable information and support for families in need [5].

It's important to note that public supports like Supplemental Security Income (SSI) can be impacted by family finances, and receiving money or inheritance might affect SSI eligibility for a child with ASD. Families are encouraged to establish a special needs will and trust to protect the child's money and ensure it is used for items and services not covered by federal funding programs like Medicaid or SSI. Consulting with an experienced lawyer is recommended to set up a special needs will and trust properly to safeguard the child's financial future.

Financial Planning for Families

When navigating the financial landscape for a child with autism, understanding how various factors interact is crucial. This includes how family finances can impact Supplemental Security Income (SSI) and the role of tools like special needs trusts.

Impact of Family Finances on SSI

Public supports like Supplemental Security Income (SSI) can be influenced by family finances. The amount of SSI benefits received by a child with autism may vary depending on the state, as each one has its own guidelines for payout amounts, qualifying resources, and acceptance criteria.

Receiving money or an inheritance might affect SSI eligibility for a child with Autism Spectrum Disorder (ASD). It's important to note that SSI benefits can also lead to Medicaid eligibility in most states, assisting with medical bills and potentially maintaining eligibility if home care is less costly to the government [1].

Establishing Special Needs Trusts

To protect a child's financial future and ensure continued eligibility for SSI, families are encouraged to establish a special needs will and trust. These legal tools safeguard the child's money and ensure it is used for items and services not covered by federal funding programs like Medicaid or SSI.

Establishing a special needs trust allows for long-term saving without sacrificing eligibility for public benefits. ABLE Accounts, established through the Achieving a Better Life Experience (ABLE) Act of 2014, provide a similar option for families of individuals with disabilities.

Financial Tools	Description	Impact on SSI
Special Needs Trust	A legal tool to safeguard the child's money and ensure it is used for necessary items and services.	Protects the child's SSI eligibility by not counting the trust as a personal asset.
ABLE Account	A savings option for families of individuals with disabilities, allowing for long-term expenses.	Helps save without sacrificing eligibility for public benefits such as Medicaid and SSI.

Setting up a special needs will and trust properly requires professional consultation. Families are recommended to consult with an experienced lawyer to safeguard their child's financial future. Proper financial planning can help ensure that the child's needs are met and that they continue to thrive.