DI 12027.007 Who May Elect Statutory Benefit Continuation (SBC)
A. Policy – Individuals Who May Elect SBC
The option to elect SBC only applies to the following individuals:
1. Title II
Primary disability insurance beneficiaries.
Auxiliaries receiving benefits on the record of a primary disability beneficiary. (The primary Title II beneficiary has to elect SBC for him/herself in order for the auxiliary to receive SBC. The primary disability beneficiary also must elect to continue the benefit of an auxiliary for that auxiliary to continue to receive that benefit under SBC provisions.) See DI 12027.007B.
Disabled adult children.
Mothers/fathers receiving benefits based on having a disabled adult child in their care.
Mothers/fathers receiving benefits based on having in their care a child under age 18 but over age 15 who is disabled and receiving child’s benefits.
2. Title XVI
For SSI recipients whose benefits are based on disability or blindness.
Medicaid eligibility will continue for SSI recipients electing SBC in those states where the Social Security Administration (SSA) determines Medicaid eligibility.
Individuals receiving special cash payments and/or Medicaid eligibility under Section 1619(a) and (b) Title XVI provisions may elect SBC. See SI 02302.000 regarding 1619(a) and 1619(b) cases for Title XVI.
3. Concurrent Title II/Title XVI
In a concurrent case, a beneficiary may elect to receive SBC on one title (either Title II or Title XVI) or both titles.
NOTE: See DI 12095.171 for sample exhibits of the SSA-795 Election Statement.
B. Policy – Option to Elect SBC – Title II Auxiliaries Receiving Benefits on Record of Primary Disability Beneficiary
1. Primary Beneficiary/Wage Earner
When the primary Title II beneficiary elects SBC, he/she:
2. Title II Auxiliary
May receive SBC only if the primary beneficiary also elects to have benefits/Medicare continued for that auxiliary.
Each auxiliary receiving benefits on a primary disability beneficiary record has the option to elect or decline to have benefits/Medicare continued.
Each auxiliary beneficiary (or representative payee on their behalf, where appropriate, see DI 12027.010A.) must sign a separate SBC election statement (SSA-795) to receive SBC.