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1143 Chapter 7:Worker guides • Section 7: OSIPM worker guides (07/2026) individuals who have recently begun receiving Social Security benefits. A widow or widower receiving Title II benefits from the Social Security Administration claim of a deceased spouse or deceased former spouse is eligible for OSIPM if the individual meets all of the following: • The individual must not be entitled to premium-free Medicare Part A (Hospital coverage). • The individual must have received SSI, but lost the SSI when their spouse or ex-spouse passed away because the resulting Social Security widow/widower’s disability benefit exceeded the SSI amount. Note: The individual must be receiving Title II Social Security Benefits. Receiving railroad retirement benefits (RRB) is not countable as widow/widower income---it must be Social Security Benefits. The individual is deemed to meet the SSI income limit, but must continue to meet all other SSI eligibility criteria (including resources). There is no longer any age limit for this protected group. When a protected widow/widower needs long-term care services, they do not need to pay a liability when in a waivered service setting or in certain mental health settings (see 461-160-0610). However, they will need to pay a liability in other care settings (for example, in a nursing facility). Widow/widower OSIPM eligible individuals are usually receiving SSI and Medicaid when their spouse dies. When the widow/widower Social Security benefits begin, the amount exceeds the SSI amount, which causes the SSI to terminate. If the individual is not eligible for premium-free Medicare Part A, authorize protected eligibility under this policy. For any widow/widower determined eligible, be sure the details of the determination are clearly noted. This makes it possible for anyone else reviewing the case to easily identify how the determination was made and prevents questions about eligibility in the future. For example, you might need to add a case note with the following: • Individual lost their SSI October 2007 because they began receiving widow/widower’s benefits in a higher amount. • Individual is not eligible for premium-free Medicare Part A. Widows/widowers who have been determined OSIPM eligible can lose the status when their situation changes. For example: • They could accumulate or receive resources in excess of the $2,000.00 resource limit. • They could get married to a spouse with countable assets that causes them to be over-resources. • They could become eligible for premium-free Medicare Part A. • For this reason, it is very important to update the individual’s resources at each review. Other resources OSIPM Protected Eligibility Covers OSIPM Protected Eligibility and provides guidance to staff on how to enter these cases into ONE. It also provides guidance on 1619(b) cases and the SSI Discontinuance screen.