# SSR 78-9: SSR 78-9: Rescinded 1982

> Federal · Rulings · Rescinded

URL: https://www.frixlaw.com/law-library/statutes/SSA_SSR_SSI_SSR_78_9

## Section

- **Citation:** SSR 78-9
- **Heading:** SSR 78-9: Rescinded 1982
- **Jurisdiction:** Federal
- **Kind:** Rulings
- **Status:** Rescinded
- **Text as of:** August 14, 2026
- **Source:** Compiled text
- **Location:** Social Security Rulings / SSI / Eligibility / SSR 78-9

## Text

SSR 78-9

PURPOSE:

To state new policy requiring separate computations of Federal
supplemental security income (SSI) benefits for an eligible individual and
his eligible spouse when one is in a hospital, skilled nursing facility,
or intermediate care facility which is receiving payments under a State
plan approved under title XIX.

CITATIONS (AUTHORITY):

Sections 1611(b), 1611(e)(1)(B)(ii) as amended by Section 502 of Public
Law 94-566, 1612, 1631(a)(2) of the Social Security Act; Sections
416.120(c)(5), 416.231(a)(2), 416.231(b)(5), 416.248(c), 416.424, 416.430,
416.432(b), 416.432(c), 416.1040(a), 416.1040(c(1) and 416.1146 of
Regulations No. 16 (20 CFR Chap. III).

PERTINENT HISTORY:

In determining SSI benefits for an eligible individual and his eligible
spouse, one of whom is throughout any month in an institution receiving
payments under a State plan approved under title XIX (hereinafter referred
to as a "Medicaid facility") the reduction in the rate of payment required
by section 1611(e)(1)(B)(ii) of the Act due to such confinement, has
heretofore applied to the couple as an entity, and there have been no
separate computations for each member. That is, the maximum rate of
payment for a couple under section 1611(b)(2) of the Act (currently
$3,021.60 per year) was reduced to the sum of the maximum payable to an
individual under section 1611(b)(1) of the Act (currently $2,013.60 per
year) plus $300 ($25 per month), the maximum payable to an individual in a
Medicaid facility in a year, and the total thus produced became the
maximum rate of payment per year for such eligible individual with an
eligible spouse. This, in turn, was subject to reduction by the countable
income chargeable to them as a couple. The total was then disbursed in
amounts of not more than $25 per month to the member in the Medicaid
facility, and the remainder to the other member, or in equal amounts if
the total did not exceed $50.
he
maximum rate of payment per year for such eligible individual with an
eligible spouse. This, in turn, was subject to reduction by the countable
income chargeable to them as a couple. The total was then disbursed in
amounts of not more than $25 per month to the member in the Medicaid
facility, and the remainder to the other member, or in equal amounts if
the total did not exceed $50.

In the event the noninstitutionalized member of the couple was living
throughout a month in the household of another from whom he was receiving
support and maintenance, computation of the rate of payment as described
above was modified so as to reduce the rate of payment to such member of
the couple as an individual under section 1611(b)(1) by one-third, in
accordance with section 1612(a)(2)(A) of the Act and section 416.432(c) of
the regulations. In the event an essential person was living with the
couple, the payment increment attributable to the essential person was
added to the rate of payment for the couple. Where there was a separation,
retention of essential person status depended on whether the essential
person continued to reside with a qualified individual. However, where the
qualified individual is temporarily absent from home (as would be the case
where confined to a Medicaid facility for not more than 6 months), the
increment to the rate of payment because of the presence of the essential
person is, under the regulations (section 416.248(c)), allowed to continue
until 6 full months elapse or earlier where evidence indicates that the
qualified individual does not intend to return to the home. Consequently,
confinement in a Medicaid facility did not necessarily terminate the
essential person increment or affect the rate of payment to the couple.
he presence of the essential
person is, under the regulations (section 416.248(c)), allowed to continue
until 6 full months elapse or earlier where evidence indicates that the
qualified individual does not intend to return to the home. Consequently,
confinement in a Medicaid facility did not necessarily terminate the
essential person increment or affect the rate of payment to the couple.

In all such cases of confinement to which the reduced rates of payment
applied, such reduction was predicated by law (section 1611(e)(1)(B)) and
regulation (see section 416.231(b)(5) of the regulations) on the receipt
by the institution of more than 50 percent of the cost of services being
provided by title XIX funds on behalf of the individual so confined.

The policies described above are applicable to the computation of payment
rates for such an eligible couple for all months prior to October 1976.
However, Section 502 of Public Law 94-566 amended Section
1611(e)(1)(B)(ii) of the Social Security Act to provide a new method of
computation and payment for an eligible individual with an eligible spouse
when one of them is so confined throughout a month.

POLICY DIRECTIVE STATEMENT:

Effective October 1976, for the purposes of computing and paying SSI
benefits to an eligible individual with an eligible spouse when one of
them is throughout a month in an institution which is receiving payments
of more than 50 percent of the cost of services under a State plan
approved under title XIX, each member of the couple will be treated as an
individual; for each of these months the benefit payment to each
individual will be computed separately in accordance with the following
formula:
eligible spouse when one of
them is throughout a month in an institution which is receiving payments
of more than 50 percent of the cost of services under a State plan
approved under title XIX, each member of the couple will be treated as an
individual; for each of these months the benefit payment to each
individual will be computed separately in accordance with the following
formula:

- From the maximum rate prescribed for an individual under section
1611(b)(1) of the Act, there will be deducted the countable income of the
member of the couple who is not in a Medicaid facility, computed as if he
were an eligible individual who does not have an eligible spouse and
without regard to any income of the other eligible member of the couple.
That is, the amount specified in section 1611(b)(1) of the Act (after
reduction by one-third, if such noninstitutionalized individual is living
in the household of another as required by section 1612(a)(2)(A) of the
Act) will be reduced by the amount of such individual's income, if any,
that is not excludable under section 1612(b) of the Act (Subpart K of
Regulations No. 16 generally), or excludable under any other Federal
statute. (Section 416.1146 of such Subpart K). The difference, if any,
will be the amount of the Federal SSI payment to the eligible spouse who
is not confined in a Medicaid facility.

- From the maximum rate prescribed for an individual in a Medicaid facility
under section 1611(e)(1)(B)(ii) of the Act, there will be deducted the
countable income of the member who is confined throughout any month in a
Medicaid facility, computed as if such member were an individual and
without regard to any income of the institutionalized eligible member of
the couple. That is, the rate specified in 1611(e)(1)(B)(ii), namely $300
per year, will be reduced by the amount of such individual's income, if
any, that is not excludable under section 1612(b) of the Act (Subpart K of
the Regulations No
h in a
Medicaid facility, computed as if such member were an individual and
without regard to any income of the institutionalized eligible member of
the couple. That is, the rate specified in 1611(e)(1)(B)(ii), namely $300
per year, will be reduced by the amount of such individual's income, if
any, that is not excludable under section 1612(b) of the Act (Subpart K of
the Regulations No. 16, generally) or excludable under any other Federal
statute (Section 416.1146 of such Subpart K). The difference, if any, will
be the amount of the Federal SSI payment to the eligible spouse confined
in a Medicaid facility.

- In the event an essential person(s) is living with the couple at the time
the eligible individual or spouse enters the Medicaid facility, and the
separation is temporary (section 416.1040(c)(1), the income deemed from
the essential person(s), if any, will be added to the income of the
noninstitutionalized individual, and the essential person(s) increment(s)
will be added to the benefit rate for the noninstitutionalized individual.
The above is applicable even though the confined member is the sole
qualified person.

- Federally administered State supplementary payments and State
administered mandatory minimum supplements will be computed in the same
manner as stated in this Policy Directive Statement, that is, when Public
Law 94-566 applies, the State supplementary payment level (combined
Federal plus State) applicable for an individual is used for the
noninstitutionalized member.

- The computation and payment polices prescribed in the preceding
paragraphs of this Policy Directive Statement are applicable for each
month in which an eligible individual or eligible spouse remain in a
Medicaid facility throughout a month.
ies, the State supplementary payment level (combined
Federal plus State) applicable for an individual is used for the
noninstitutionalized member.

- The computation and payment polices prescribed in the preceding
paragraphs of this Policy Directive Statement are applicable for each
month in which an eligible individual or eligible spouse remain in a
Medicaid facility throughout a month.

From the maximum rate prescribed for an individual under section
1611(b)(1) of the Act, there will be deducted the countable income of the
member of the couple who is not in a Medicaid facility, computed as if he
were an eligible individual who does not have an eligible spouse and
without regard to any income of the other eligible member of the couple.
That is, the amount specified in section 1611(b)(1) of the Act (after
reduction by one-third, if such noninstitutionalized individual is living
in the household of another as required by section 1612(a)(2)(A) of the
Act) will be reduced by the amount of such individual's income, if any,
that is not excludable under section 1612(b) of the Act (Subpart K of
Regulations No. 16 generally), or excludable under any other Federal
statute. (Section 416.1146 of such Subpart K). The difference, if any,
will be the amount of the Federal SSI payment to the eligible spouse who
is not confined in a Medicaid facility.

From the maximum rate prescribed for an individual in a Medicaid facility
under section 1611(e)(1)(B)(ii) of the Act, there will be deducted the
countable income of the member who is confined throughout any month in a
Medicaid facility, computed as if such member were an individual and
without regard to any income of the institutionalized eligible member of
the couple. That is, the rate specified in 1611(e)(1)(B)(ii), namely $300
per year, will be reduced by the amount of such individual's income, if
any, that is not excludable under section 1612(b) of the Act (Subpart K of
the Regulations No
h in a
Medicaid facility, computed as if such member were an individual and
without regard to any income of the institutionalized eligible member of
the couple. That is, the rate specified in 1611(e)(1)(B)(ii), namely $300
per year, will be reduced by the amount of such individual's income, if
any, that is not excludable under section 1612(b) of the Act (Subpart K of
the Regulations No. 16, generally) or excludable under any other Federal
statute (Section 416.1146 of such Subpart K). The difference, if any, will
be the amount of the Federal SSI payment to the eligible spouse confined
in a Medicaid facility.

In the event an essential person(s) is living with the couple at the time
the eligible individual or spouse enters the Medicaid facility, and the
separation is temporary (section 416.1040(c)(1), the income deemed from
the essential person(s), if any, will be added to the income of the
noninstitutionalized individual, and the essential person(s) increment(s)
will be added to the benefit rate for the noninstitutionalized individual.
The above is applicable even though the confined member is the sole
qualified person.

Federally administered State supplementary payments and State
administered mandatory minimum supplements will be computed in the same
manner as stated in this Policy Directive Statement, that is, when Public
Law 94-566 applies, the State supplementary payment level (combined
Federal plus State) applicable for an individual is used for the
noninstitutionalized member.

The computation and payment polices prescribed in the preceding
paragraphs of this Policy Directive Statement are applicable for each
month in which an eligible individual or eligible spouse remain in a
Medicaid facility throughout a month.

DOCUMENTATION:
supplementary payment level (combined
Federal plus State) applicable for an individual is used for the
noninstitutionalized member.

The computation and payment polices prescribed in the preceding
paragraphs of this Policy Directive Statement are applicable for each
month in which an eligible individual or eligible spouse remain in a
Medicaid facility throughout a month.

DOCUMENTATION:

Evidence that one member of a couple is in a hospital, skilled nursing
facility or intermediate care facility throughout a month, and that such
institution is receiving payments of more than 50 percent of the cost of
services on behalf of the individual under a State plan approved under
title XIX will be obtained.

FURTHER INFORMATION:

The amended rules, as described above, for computing benefits where a
member of a couple is in a Medicaid facility are not applicable to a
determination of initial eligibility for such couple; the rules for
determinations of eligibility applicable prior to the enactment of Section
502 of Public Law 94-566 will continue in effect. In other words, upon
application, a couple's eligibility will be determined based on a
couple's benefit amount and a couple's resource limit, and where
applicable computation and payment to the eligible individual and eligible
spouse will be based on the formula set out in the above Policy Directive
Statement. The application resources limit continues to be that of a
couple ($2,250.00). The effect of Section 502 of Public Law 94-566 was to
amend title XVI for computation and payment purposes when one member of an
eligible couple is confined throughout a month in an institution and the
institution is receiving payments of more than 50 percent of the cost of
services on behalf of the individual under a State plan approved under
title XIX
be that of a
couple ($2,250.00). The effect of Section 502 of Public Law 94-566 was to
amend title XVI for computation and payment purposes when one member of an
eligible couple is confined throughout a month in an institution and the
institution is receiving payments of more than 50 percent of the cost of
services on behalf of the individual under a State plan approved under
title XIX. Policies related to such areas as liability for overpayments
are not changed by the above policy statement in view of the fact that
this section of the law as amended does not change eligibility status of
the couple.

## Nearby sections

- [SSR 75-32 SSR 75-32: Rescinded 1981](https://www.frixlaw.com/law-library/statutes/SSA_SSR_SSI_SSR_75_32.md)
- [SSR 76-7 SSR 76-7: SECTION 1611(e)(1)(A) and (B) (42 U.S.C. 1382(e)(1)(A) and (B)) -- SUPPLEMENTAL SECURITY INCOME -- ELIGIBILITY DUE TO INSTITUTIONAL STATUS](https://www.frixlaw.com/law-library/statutes/SSA_SSR_SSI_SSR_76_7.md)
- [SSR 76-27 SSR 76-27: SECTION 1614(d)(2) and 1614(f)(1) (42 U.S.C. 1382c(d)(2) and 1382c(f)(1)) -- SUPPLEMENTAL SECURITY INCOME -- MARITAL RELATIONSHIP](https://www.frixlaw.com/law-library/statutes/SSA_SSR_SSI_SSR_76_27.md)
- [SSR 76-28 SSR 76-28: SECTIONS 1611(b)(2), 1612(a), and 1614(b) (42 U.S.C. 1382(b)(2), 1382a(a), and 1382c(b)) -- SUPPLEMENTAL SECURITY INCOME -- AMOUNT OF BENEFITS -- RELATIONSHIP](https://www.frixlaw.com/law-library/statutes/SSA_SSR_SSI_SSR_76_28.md)
- [SSR 76-41 SSR 76-41: SECTION 1614(b) (42 U.S.C. 1382c(b)) -- SUPPLEMENTAL SECURITY INCOME -- DEFINITION OF ELIGIBLE SPOUSE](https://www.frixlaw.com/law-library/statutes/SSA_SSR_SSI_SSR_76_41.md)
- [SSR 76-42 SSR 76-42: Rescinded 1985](https://www.frixlaw.com/law-library/statutes/SSA_SSR_SSI_SSR_76_42.md)
- [SSR 77-10 SSR 77-10: SECTION 1611(e)(1)(A) (42 U.S.C. 1382(c)(1)(A)) -- SUPPLEMENTAL SECURITY INCOME -- ELIGIBILITY -- STATUS OF INSTITUTION](https://www.frixlaw.com/law-library/statutes/SSA_SSR_SSI_SSR_77_10.md)
- [SSR 77-20 SSR 77-20: SECTION 1611(e)(1) (42 U.S.C. 1382(e)(1)) -- SUPPLEMENTAL SECURITY INCOME -- ELIGIBILITY -- INSTITUTIONALIZATION THROUGHOUT A MONTH](https://www.frixlaw.com/law-library/statutes/SSA_SSR_SSI_SSR_77_20.md)
- [SSR 78-9 SSR 78-9: Rescinded 1982](https://www.frixlaw.com/law-library/statutes/SSA_SSR_SSI_SSR_78_9.md)
- [SSR 79-5c SSR 79-5c: Rescinded 1982](https://www.frixlaw.com/law-library/statutes/SSA_SSR_SSI_SSR_79_5c.md)
- [SSR 79-6 SSR 79-6: SECTION 1611(e)(1)(A) (42 U.S.C. 1382(e)(1)(A)) SUPPLEMENTAL SECURITY INCOME -- ELIGIBILITY -- EFFECT OF BRIEF ABSENCES FROM PUBLIC INSTITUTION](https://www.frixlaw.com/law-library/statutes/SSA_SSR_SSI_SSR_79_6.md)
- [SSR 79-8 SSR 79-8: Rescinded 1986](https://www.frixlaw.com/law-library/statutes/SSA_SSR_SSI_SSR_79_8.md)
- [SSR 79-16 SSR 79-16: Rescinded 1986](https://www.frixlaw.com/law-library/statutes/SSA_SSR_SSI_SSR_79_16.md)
- [SSR 79-25 SSR 79-25: Rescinded 1982](https://www.frixlaw.com/law-library/statutes/SSA_SSR_SSI_SSR_79_25.md)

---

Source: Frix Law Library, https://www.frixlaw.com/law-library/statutes/SSA_SSR_SSI_SSR_78_9. Check the current official text before relying on it. Not legal advice.
