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Health Care Finance and Administration Section: General Administrative Procedures and Compliance Policy Manual Number: 200.015 Chapter: Application for Other Program Benefits
• At least age 62; or • Disabled based on Social Security criteria; or • Is a child under 18 of a deceased, retired or disabled worker; or • Is the child who became disabled before age 22 of a deceased, retired or disabled worker.
d. SSI
An individual who is:
• At least age 65; or • Disabled or blind based on Social Security criteria; and • Has monthly income limited to the amount of the current SSI Federal Benefit Rate (FBR) or less, if living in the household of another; and • Has resources limited to $2,000 for an individual or $3,000 for a couple.
e. Veterans’ Benefits
An individual who is:
• A veteran of services in the U.S. Armed Forces and discharged under conditions other than dishonorable; or • A dependent or surviving spouse of a veteran.
f. Workers’ Compensation
An individual:
• Injured or disabled on the job; or • The surviving dependent of a worker who was killed on the job.
4. Good Cause
An individual is considered to have good cause for failure to apply for other benefits if he or she does not have someone available to act on his or her behalf AND he or she cannot apply. Examples of good cause include, but are not limited to, the following:
• The individual is not able to apply for benefits due to his or her own illness (explain that the Social Security Administration (SSA) can have a telephone interview); OR • The individual applied for benefits at one time, was denied, and he or she remains ineligible for the same reason. The individual is considered to have good cause for failure to apply if HCFA failed to advise them of the availability of other benefits. March 10, 2015 HCFA 2