Will Social Security Pay for Assisted Living

Social Security is the term used for the Old-Age, Survivors, and Disability Insurance (OASDI) program, run by the federal agency, Social Security Administration (SSA). 

Social Security is the foundation of economic security for millions of Americans—retirees, disabled persons, and families of retired, disabled or deceased workers. It is mostly about retirement benefits, it also provides survivor benefits and disability income.

Will Social Security Pay for Assisted Living

The minimum age to claim is 62. If you are turning 62 and need the income from Social Security to support yourself, you might want to start claiming your benefits now.

The federal social security insurance money can cover your assisted living costs but the social security income alone is not enough to sustain you.

The financial challenges of paying for assisted living and other senior care costs are always dreaded by many seniors. Especially when long term care services, skilled nursing, and medical costs start eating into their savings.

Without a monthly income, the most likely ways to pay for assisted living costs are through “out-of-pocket”, investment income, savings, and other personal assets. Others may choose to rely on their SSI payment but this might not be enough.

This is where you should consider the Optional State Supplements and other financial aid.

Will Social Security Pay for Assisted Living

The short answer is YES.

Social Security through the little-known Optional State Supplements offers financial assistance for seniors who reside in assisted living facilities and communities. These benefits will be available to you only if you meet the eligibility criteria set down by the federal authorities.

Let’s take a look at how much financial assistance you can make use of through the Social Security payment.

The Social Security insurance payment in 2020 is $1,503.00, which comes to $18,036 annually.

Of course, Social Security benefits vary based on your lifetime earnings during work, which is when would have paid Social Security taxes.

Now, you may already know there is a cap on how much income Social Security takes into account when calculating someone’s benefits. In 2019, the cap set to be $137,700. Any income above that amount is not taken into account for the purpose of calculating benefits.

This means that the maximum Social Security benefits a retiree who filed in 2020 at full retirement age would have received is $3,011 per month. This comes to $36,132 per year.

Payment for Assisted Living

Now, here’s where the matter gets complicated: The maximum amount (cap) had been fixed so close to the lowest average assisted living costs in the country that most retirees would have had little to no money for assisted living costs.

This means that they would have had to add more money to cover the cost of the assisted living facility or nursing home. This additional money would have had to come from income from a pension, a 401(k), or other investments or savings.

As we’ve just noted, many senior citizens often cover assisted living costs using various private funds.

So what can you do in the situation where Social Security payment is not enough to cover your assisted living program?

There are some government programs and financial channels aside from the Social Security benefits that can help pay for assisted living.

You only need to know what these financial assistant programs are to take advantage of all the government programs made available to an older adult. These can help in paying for your assisted living costs and we’ll look at how you can put the benefits together with Social Security for creating sufficient funds to pay for assisted living.

Before we move on further, we suggest you take a look at how to calculate your Social Security payments so that you get a fair idea of what to expect and how to make good use of the money earned through this federal program.

SSI Eligibility Requirements

If you are wondering what SSI is, Supplemental Security Income is the federal financial help given to seniors with limited income and assets.

To qualify for SSI, the government will first, evaluate your income. Afterward, they will supplement the necessary money to fill in the gap and bring income up to a pre-established amount.

Many people who are eligible for Supplemental Security Income (SSI) may also be entitled to receive Social Security benefits.

In fact, the application for SSI benefits is also an application for Social Security benefits. We often need to obtain additional information from the person before we can award Social Security benefits.

Eligibility Conditions for Social Security Benefits as a Worker:

You must be:

  • Aged 62 or older, or disabled or blind; and
  • Insured by having enough work credits.

What Are Optional State Supplements (OSS)?

Optional State Supplements (OSS) are state-based financial help that is offered on top of the federal Supplemental Security Income (SSI). They are sometimes referred to as State Supplementary Payments (SSP).

There are states where seniors living in assisted living facilities can qualify for OSS. These are financial benefits that are generally based on your level of income and may help in paying for room and board costs at the facilities. You have to keep in mind that you can be eligible for OSS benefits if you qualify for SSI benefits. This means that the OSS benefits may be provided on top of the SSI benefits.

Remember, you don’t get the OSS benefits directly as you do with your Social Security benefits or SSI benefits. Instead, the OSS benefits are paid straight to the assisted living facility.

Optional State Supplements

How Does Optional State Supplement Works?

We have to admit that the Optional State Social Security Supplements are pretty much complicated and confusing to get a grasp on. Lucky for us, there is only one point that we need to understand when it comes to OSS

All you need to focus on is that states can help low-income retirees afford assisted living costs in two ways:

  • By paying for assisted living room and board costs through OSS
  • By limiting the amount of money that assisted living facilities can charge for room and board

Eligibility for Optional State Supplements

Each state sets its own eligibility rules but most states generally base eligibility on an individual’s income. For example, you can be eligible for OSS if your income level is at or below the federal SSI benefit level.

What we are saying is that the amounts of money available through OSS benefits as well as the eligibility rules may vary from state to state.

We know that some states may choose to set the income cut-off higher or lower than the federal SSI level. When it comes to OSS eligibility criteria, keep in mind that some states may choose an entirely different scale when setting income eligibility level or the general eligibility criteria for OSS.

Monthly Income: To be eligible for the federal SSI benefit, every individual has to prove that they had a monthly income (individually and combined with a partner) of less than the set amount for that year.

Senior Living Arrangement: It goes without saying that to be eligible for Optional State Supplements, you also have to live in an assisted living facility or adult foster care home to be considered. States have different definitions as to what entails assisted living or adult foster care, so we suggest that you take it upon yourselves to find out how your state defines assisted living or adult foster care. 

How Does Location Matter When it Comes to Optional State Supplements?

Keep in mind that some states such as Kansas, Washington, Alabama, and Mississippi do not offer OSS benefits while the rest of them do.

Also, some states even cap the amount that assisted living facilities can charge for room and board to match the federal Supplemental Security Income benefits. You can find such an arrangement in states like Indiana and Ohio. What it means is that as a senior who qualifies for SSI benefits, you can easily afford to pay for assisted living costs using such SSI benefits.

Social Security Financial Assistance for Assisted Living

Please note that not all assisted living facilities have to hold good to this cap. An assisted living facility can choose to charge as much as they want as long if they do not accept Medicaid. In other words, only assisted living facilities that accept Medicaid are subject to these caps.

Documents Required to Apply for Optional State Supplements

The administering agencies and application processes for OSS may vary in each state. For example, we know that some states base their eligibility on Medicaid. This means that you automatically become eligible for SSI and OSS if you’re cleared to receive the benefits for Medicaid.

On the other hand, there are some states that may require you to apply directly to receive Optional State Supplements benefits.

Now, here are some of the documents that you must provide for evidence of eligibility.

Proof of age (the older adult must be aged 65 and above)

  • Social Security Number
  • Proof of income
  • Proof of citizenship
  • Proof of living arrangements (you need to prove that you’re living in an assisted living facility or adult foster care facility)
  • Work history

We hope that you found the information in this article helpful and informative. We would love to hear from you if you have any suggestions!

Do let us know in the comments below.