Social Security & Medicare

Detailed coverage of Social Security, Medicare, Medicaid, and other programs. Fast answers to frequently asked retirement, disability, and Medicare questions.

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About the Social Security & Medicare

Social Security & Medicare Tab Contents

Tab	Tab Title
Tab 1	Social Security Eligibility
Full Retirement Age Chart Amount of Wages or Self-Employment Income Necessary to Obtain a Credit Chart Social Security Overview Contact Information Purpose Social Security Administration (SSA) Programs Included Under the Social Security Act and Related Laws Obtaining a Social Security Card Social Security Numbers for Noncitizens Taxpayer Identification Number (TIN) Application for Benefits Duty to Report Certain Events International Social Security (Totalization) Agreements Non-Covered Workers Eligibility for Monthly Social Security Payments Reporting to Social Security Becoming Insured Insured Status Determining Insured Status Earning Social Security Credits Self-Employment Credits Work in a Foreign Country Earnings Records and Tax Reports Social Security Number (SSN) Earnings Record Correcting an Earnings Record Employees Employer Corporate Officers Common-Law Test Factors Which Show Control Exceptions to Common-Law Test Farm Crew Workers Wages Actual or Constructive Payment Self-Employment Trade or Business Exclusions from Trade or Business Partnership Royalties Nonprofessional Fiduciaries Business Carried on in an Estate or Trust Mail Carriers Land Owner Sharefarmer Newspaper Vendors Employees of Foreign Governments State and Local Government Employees Public Officials Federal Court Reporters Exemption for Religious Orders Self-Employed Ministers, Members of Religious Orders, and Christian Science Practitioners Church Employees Crews of Fishing Boats Real Estate Agents and Direct Sellers Net Earnings From Self-Employment Who Must File Methods for Calculating Net Earnings Regular Method Farm Optional Method Nonfarm Optional Method Using Both Optional Methods Special Coverage Provisions Cash-Pay Test Agricultural Labor Household Employment Work by a Student for a School Student Nurse Hospital Intern Employment Not in the Course of the Employer's Trade or Business Family Employment Delivering or Distributing Newspapers Nonprofit Organizations Ministers and Members of Religious Orders Crews on Fishing Boats Employment for a Foreign Government, International Organization, or Instrumentality of a Foreign Government Foreign Students and Exchange Visitors Employment as Civilian for the U.S. Government Employees for the District of Columbia Federally Sponsored Programs Member of the U.S. Armed Forces Employment Outside the U.S. Guam and American Samoa Commonwealth of the Northern Mariana Islands (CNMI) Railroad Retirement Act Included-Excluded Rule State and Local Government Employees Social Security Coverage Section 218 Agreement Mandatory Coverage Section 218 Agreement Effective Date Types of Work Not Covered by Section 218 Agreements Coverage Groups Termination of Section 218 Agreements Police Officers and Firefighters Public Transportation System Employees Positions Compensated Solely by Fees Rehired Annuitants
Tab 2	Social Security Benefits
Annual Retirement Earnings Test Exempt Amounts Chart Countries with Qualifying Social Insurance or Pension Systems Chart U.S. Treasury Department Restricted Countries for Payments Chart SSA Restricted Countries for Payments Chart Retirement Insurance Benefits Summary When Monthly Benefits Can Begin Entitlement to Benefits Amount of Benefits Railroad Retirement Benefits (RRB) Tier I and Tier II Tier I Benefits Tier II Benefits Filing a Claim Application Signing the Application When to File Applications Individuals Nearing Retirement Age Delay in Filing Where to File Department of Veterans Affairs or Railroad Retirement Board Application Considered Filed Valid Applications Completing the Application Retroactive Effect of Application Restricted Retroactivity Right to Withdraw an Application Evidence Required for Benefits Types of Evidence Proof of Age Parent-Child Relationship Child Age 18–19 Marriage Death Child in Care U.S. Citizenship Wages Representative Payees Representative Payees Evidence Selecting Payees Notification Responsibilities of Representative Payee Computing the Cash Benefit Rate Average Indexed Monthly Earnings (AIME) Primary Insurance Amounts (PIA) Computation Allocation of Self-Employment Income Special Minimum PIA Windfall Elimination Provision (WEP) Cost-of-Living Adjustments (COLA) Delayed Retirement Credit Recomputation of the PIA Reduced Benefit Rate Making the Reduction Recomputing the Reduced Benefit Rate Basic Reduction Formulas Effect of Basic Reduction Formulas Computing Reduction Months Computing Reduction Amount Maximum Monthly Benefits on One Earnings Record Underpayments and Overpayments Underpayments Overpayments Reduction or Nonpayment of Social Security Benefits Earnings Test Foreign Work Test Child in Care Requirement Good Cause Workers' Compensation or Disability Benefits Governmental Pension Conviction of Subversive Activities Deportation Aliens Confinement in a Correctional Institution Marriage Outstanding Warrants Additional Events That Can End Entitlement Benefits
Tab 3	Social Security Taxation and Planning
Taxation of Social Security Benefits Taxation Taxable and Nontaxable Benefits Railroad Retirement Benefits Form W-4V, Voluntary Withholding Request Form SSA-1099, Social Security Benefit Statement Form RRB-1099, Payments By the Railroad Retirement Board Lump-Sum Payments Investments to Reduce Taxes for Social Security Benefits Tax Issue Applicable Tax Law Tax Planning Strategies Possible Risks Court Case When to Start Collecting Social Security Benefits Issue Applicable Law Tax Planning Strategies Examples Possible Risks How Work Affects Retirement Benefits Benefits and Tax Issues Applicable Tax Law Planning Strategies Examples Social Security and Railroad Retirement Taxation by State Social Security Benefits Worksheet
Tab 4	Disability (SSDI)
Recent Work Test for Disability Eligibility Chart Comparison of SSDI and SSI Disability Programs Chart Duration of Work Test for Disability Eligibility Chart Disability Benefits Contact Information Qualifications Cash Disability Benefits and Related Disability Protection Entitlement to Benefits Eligibility Auxiliary Benefits Waiting Period Amount of Benefit Reduction or Offset of Benefit Effect of Outside Benefits on Social Security Disability Benefits Payable Lump-Sum Payments Disabled Worker's Benefits Not Paid Disabled Worker's Cash Benefits End Medicare Coverage Restarting Benefits Definition of Disability Disability Definition Medically Determinable Impairment Substantial Gainful Activity Disability Determinations Independent Determinations Percentage of Disability Evidence of Not Disabled Listing of Impairments Compassionate Allowances Condition Does Not Meet Listing Age, Education, and Work Experience Employment Quality Assurance and Appeals Evidence of Disability Required Evidence Categories of Evidence Period of Disability Establishing a Period of Disability Disability Status Ceases The Ticket to Work and Self-Sufficiency Program Work Incentives Planning and Assistance and Protection And Advocacy Trial Work Period Incentive for Rehabilitation Month of Service Guidelines Benefits Not Payable Ineligibility Beginning and Ending of Trial Work Period Reporting to Social Security Administration (SSA) Required Reporting of Certain Events Compassionate Allowances Conditions List
Tab 5	Medicare and Supplemental Insurance
Medicare Monthly Premiums Chart Medicare Coverage Choices at a Glance Chart Standard Drug Benefit (Part D) Chart Medicare Savings Programs Income and Resource Limits Chart Basics of Medicare Contact Information The Four Parts of Medicare Medicare and the Coronavirus (COVID-19) Medicare Coverage Choices Eligibility Medicare Savings Programs Enrollment Periods Late Enrollment Penalties Medicare Part A Hospital Care Hospice Home Health Services Medicare Part B Medicare Part B Costs Clinical Research Studies Ambulance Services Durable Medical Equipment (DME) Mental Health Care Prescription Drugs (Outpatient) Preventive Services Services Not Covered Medicare Part C Medicare Advantage Plans Health Maintenance Organization (HMO) Plans Preferred Provider Organization (PPO) Plans Private Fee-for-Service (PFFS) Plans Medicare Special Needs Plans (SNP) Medicare Medical Savings Account (MSA) Plans Other Medicare Health Plans Medicare Part D Prescription Drug Coverage What Drug Plans Cover Coverage Rules Standard Drug Benefits Coverage Gap Medication Therapy Management Programs Medicare Part D and Other Insurance Supplemental Insurance (Medigap) Contact Information Coordination of Benefits Retiree Health Insurance Medicare Supplement Insurance (Medigap) Medigap and Medicare Advantage Plans Medigap Rights Medicare Coverage Choices at a Glance Medigap Guaranteed Rights
Tab 6	Supplemental Security Income SSI
Federal Benefit Rates (FBR) — SSI Chart How Income Affects SSI Benefits Chart SSI Recipient Statistics Chart Comparison of SSDI and SSI Programs Chart SSI Terms Chart Supplemental Security Income (SSI) Contact Information SSI Overview Basic Principles of SSI SSI Payment Date State Supplements Mandatory Payments Optional Payments Coordination With Medicaid Supplemental Nutrition Assistance Program (SNAP) Eligibility for SSI Categories of Eligibility Income and Property Limitations Other Requirements SSI Eligibility for Aliens Absence From the United States Filing for Other Benefits Fugitive Felons Probation and Parole Violators Institutionalization Marriage and SSI Eligibility Under More Than One Category Continuing Eligibility Recipient Reporting Requirements Fraud Income Income Defined Countable Income Earned Income Unearned Income lncome and SSI Benefits Assistance Related to Disasters Assistance for Home Energy or Support and Maintenance In-Kind Income One-Third Reduction Rule Presumed Maximum Value Rule Temporary Absences Acting as an Agent SSI Resources Resources Effect on SSI Benefits SSI Resources Liquid and Non-Liquid Resources Resources Not Considered SSI Resources Ownership of Resources Countable Resources Valuation of Resources Resource Exclusions Resources Affected by Disaster Real Property That Cannot Be Sold Conditional SSI Payments Disposal of Resource at Below Market Value Deeming of Income and Resources Deeming Situations Ineligible Spouse to Eligible Individual Parent to a Child Sponsor to an Alien Essential Person to an Eligible Qualified Individual Work Incentives for the Blind or Disabled Purpose of Work Incentives Continuity of Benefits Impairment-Related Work Expenses (IRWE) Work Expenses of the Blind Plan to Achieve Self-Support (PASS) Disabled Engaged in Substantial Gainful Activity Medicaid While Working Restarting SSI Cash Benefits if Benefits Ended Because of Earned Income Federal SSI Payment Amount Federal Benefit Rate (FBR) Maximum Monthly SSI Benefit State Supplementary Payments Computation of Payments Retrospective Monthly Accounting (RMA) Proration of SSI Payments Windfall Offset Interim Assistance Reimbursement Direct Field Office Payments Presumptive Blindness or Presumptive Disability Payments Appeals
Tab 7	Survivors, Spouses, Children
Spousal Benefits Chart Family Benefits Chart Survivor's Benefits Chart Spousal Benefits Contact Information Eligibility for Spousal Benefits Amount of Spousal Benefits Termination of Spousal or Divorced Spousal Benefits Eligibility for Divorced Spouse Widow(er) Benefits Eligibility for Widow(er) Benefits Definition of Widow(er) Application for Widow(er) Benefits Effect of Remarriage on Widow(er)'s Benefits Amount of Widow(er)'s Insurance Benefit Termination of Widow(er)'s Benefits Benefits for Children Eligibility for Child's Benefits Amount of Benefits Children With Disabilities
Tab 8	Medicaid and CHIP
Medicaid Eligibility Poverty Guidelines Medicaid Benefits Medicaid Funding Medicaid Spending Premiums, Copayments, and Other Cost Sharing CHIP Children's Health Insurance Program (CHIP) CHIP Eligibility Standards CHIP Benefits CHIP Cost Sharing Outreach and Enrollment for Medicaid and CHIP Telemedicine
Tab 9	Long-Term Care
Distribution and Duration of Long-Term Care Services Chart Medicare Payment For Skilled Nursing Care Chart Long-Term Care Overview Contact Information Long-Term Care Who Needs Care How Much Care is Needed Who Provides Care Where to Receive Care Who Pays for Long-Term Care How Much is Paid for Long-Term Care Accessing Long-Term Care Staying at Home Living in a Facility Long-Term Care Planning Advance Care Plan Considerations Legal Concerns Long-Term Care Costs Average Costs Cost Trends Paying for Long-Term Care Insurance Health and Disability Insurance Long-Term Care Insurance Life Insurance Private Payment Reverse Mortgages Annuities Trusts Medicare Medicare Coverage for Long-Term Care Hospice Care Medicaid — Long-Term Care Medicaid Medicaid Eligibility Applying for Medicaid Medicaid Estate Recovery Medicaid Appeals Program of All-Inclusive Care for the Elderly (PACE) Veterans Affairs Benefits Programs to Help Veterans Stay in Their Homes Paying for Long-Term Care State Programs
Tab 10	Veterans Benefits
Retirement Benefits Contact Information Social Security Special Veterans Benefits Thrift Savings Plans Military Retirement Plans VA Pensions Dependents and Survivors Benefits Separation From Military Service Contact Information Transition Assistance Program (TAP) Separation Health Assessment Transitional Health Care Disability Benefits Disability VA Service Connected Disability Benefits Social Security Disability Health Care Contact Information TRICARE VA Health Care Benefits Medicare TRICARE for Life (TFL) Other VA Benefits Contact Information
Tab 11	Appeals
Medicare Level 1 and Level 2 Appeals Chart Original Medicare (Parts A & B—Fee-for Service) flowchart Social Security Representation Contact Information Representation Representative Appointment and Fee Arrangement Forms Appointing a Representative Representative Fee Agreements Social Security Appeals Contact Information Social Security Appeals Initial Determinations Review Process Steps—Appeal Levels Appeal Time Limits Extensions 1) Reconsideration 2) Administrative Law Judge Hearing 3) Appeals Council Review 4) Civil Action in Federal District Court Medicare Representation Contact Information Available Resources Self-Appointed Representative Medicare Appeals Contact Information Complaints Versus Appeals Medicare Appeals Forms Appeals Fast (Expedited) Appeals Advance Beneficiary Notice of Noncoverage Medical Summary Notice Levels of Appeal—Parts A and B Level 1: Redetermination by a Medicare Administrative Contractor (MAC) Level 2: Reconsideration by a Qualified Independent Contractor (QIC) Level 3: Decision by the Office of Medicare Hearings and Appeals (OMHA) Level 4: Review by the Medicare Appeals Council (Appeals Council) Level 5: Judicial Review in U.S. District Court Medicare Health Plan Appeals Medicare Prescription Drug Coverage Appeals Extra Help For Medicare Prescription Drug Costs Special Needs Plan (SNP) Appeals Income-Related Monthly Adjustment Amount Appeals Veterans Affairs (VA) Appeals Contact Information Veterans Affairs (VA) Appeals Forms1 VA Appeals Structure VA Appeals Process

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Social Security & Medicare

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