Disabled Widow(er)s

Background

Certain widow(er)s, age 50 through 64, whose SSI payments have been discontinued due to entitlement to, or an increase in, RSDI widow(er)s benefits are potentially eligible for Pickle MC. Eligibility continues under these provisions until they become eligible for Part A of Medicare.

The term “widows” collectively refers to widows, widowers and surviving divorced spouses.

The term “disabled widows” collectively refers to disabled widows, disabled widowers and disabled divorced surviving spouses who are eligible for the

Disabled Widow(er)s (DW) program.

DHCS Actions

Disabled Widow(er)s are listed on the monthly Exception Eligibles report as one of the SB 87 categories under the Craig v. Bontá court order.

DHCS 7089, Screening Worksheet

EWs must use the “Screening Worksheet - Disabled Widow(er) Checklist” (DHCS 7089) to screen for Disabled Widow(er) program benefits.

Criteria

To be eligible for Disabled Widow(er) Pickle benefits, an individual must meet all of the following criteria:

Is between age 50 and 64, and
Is eligible for and currently receiving any of the following widow(er)s benefits under Title II (RSDI) Section 202:
- Old-age/retirement insurance benefits
- Wife's insurance benefits
- Husband's insurance benefits
- Child's insurance benefits
- Widow's insurance benefits
- Widower's insurance benefits
- Mother's and father's insurance benefits
Is not entitled to Medicare Part A (hospital insurance), and
Has become ineligible for SSI/SSP benefits because of the receipt of the above Title II benefits.

Verification Requirements

Individuals who apply under Disabled Widow(er)s provision must have evidence of their current Title II (RSDI) benefit amount.

The EW must:

Determine if the widow(er) is currently receiving Title II (RSDI) for disability.
1. Note: Use an SCD 169 or SCD 1955 to request the information from SSA, if necessary
Verify current Title II benefits being received by the individual for reasons other than disability (for example, widow[er]s benefit amount), or
Obtain an award letter which clearly distinguishes the reason that the Title II benefit is being paid.

Budgeting

Once the screening test (above) is passed, CalWIN will compute Pickle eligibility as follows:

Amount to be disregarded:
If the widow(er) is receiving Title II benefits for any reason other than disability, disregard the entire Title II amount and the widow(er)s benefit.
When the individual currently receives Title II as a disabled person, disregard only the widow(er)s portion of the benefit award.
Use the SSI/SSP payment standard which is in effect for the month eligibility is being determined.
Send an approval or denial NOA if the person passed the screening test.
- Note: Individuals who are eligible under these provisions are identified with Aid Code 36.

Annual Redetermination (RD)

At annual redetermination (RD), EWs must:

Verify receipt of Title II widows insurance benefits,
Verify any other income, and
Determine that the individual would be SSI/SSP eligible if all Title II Section 202 benefits are disregarded.

Ineligibility

Once Medicare begins, the recipient is no longer eligible as a disabled widow.