People with Prader-Willi Syndrome in Utah may qualify for federal and state disability benefits, including SSI, SSDI, Medicaid, and ABLE accounts. This guide explains eligibility, how to apply, and what changes are coming in 2025.
To get federal disability benefits for Prader-Willi Syndrome, you must meet Social Security’s definition of disability. This means your condition must stop you from doing substantial work for at least 12 months. For children, the rules are different: a child under 18 may qualify if their condition severely limits daily activities. Adults must show they cannot do any job that pays above the Substantial Gainful Activity (SGA) limit. In 2025, SGA is $1,620/month for most people, or $2,700/month if blind. If you worked and paid Social Security taxes, you may qualify for SSDI. If you have low income and resources, you may qualify for SSI. Both programs require medical proof of disability. [^1][^5]
In Utah, people with Prader-Willi Syndrome may qualify for Medicaid if they are disabled and meet income rules. Utah’s Medicaid Aged, Blind or Disabled (ABD) program covers medical costs for disabled adults and children. If you get SSI or SSDI, you often qualify for Medicaid automatically. If not, the State Medicaid Medical Review Board can decide if you are disabled. Utah also offers Medicaid waivers for home and community-based services, which can help with care at home. These waivers may have waiting lists. Utah’s rules follow federal guidelines, but some programs may have extra state rules. [^4][^3]
Utah’s ABLE account lets people with Prader-Willi Syndrome save up to $19,000 per year in 2025 for disability-related costs. This money does not count against SSI or Medicaid income limits. You can use it for things like therapy, equipment, or education. To open an account, go to Utah’s ABLE program website. [^6]
For SSI in 2025, the federal income limit is about $943/month for an individual. For SSDI, there is no income limit, but you cannot earn more than the SGA limit ($1,620/month in 2025) and keep full benefits. For Utah Medicaid, income limits vary by program but are often higher for disabled people. [^1][^3][^5]
If your income or living situation changes, you must report it to Social Security and Medicaid. Not reporting changes can lead to overpayments and penalties. Use the SSA’s online portal or call your local office to report changes. [^5][^4]
In 2025, Social Security disability benefits will increase by 2.5% due to COLA. The SGA limit is now $1,620/month for most people, or $2,700/month if blind. These changes help keep benefits in line with rising costs.
Yes, if Prader-Willi Syndrome limits work or daily life and you meet income rules, you can get SSI in Utah. You need medical proof and to apply through Social Security.
To apply for SSDI, you need a work history and medical proof that Prader-Willi Syndrome stops you from working. Apply online at SSA.gov or at a local office.
In 2025, the SGA limit is $1,620/month for most people with disabilities. If you are blind, it is $2,700/month. Earning above this may stop your SSDI payments.
Yes, Utah Medicaid covers medical needs for people with Prader-Willi Syndrome if they meet disability and income rules. You may qualify if you get SSI or SSDI.
Yes, you can work and keep some benefits if you earn below the SGA limit. Social Security has work incentives to help you keep benefits while working.
An ABLE account lets you save up to $19,000 per year in 2025 for disability-related costs without losing SSI or Medicaid. Utah has its own ABLE program.
This guide is for informational purposes only and is not legal or financial advice. Always consult with a qualified professional for personalized guidance.
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Yes, Utah offers Medicaid waivers for home and community-based services. These can help with therapy, care, and support, but may have waiting lists.
Report changes in income or living situation to Social Security and Medicaid. Use the SSA online portal or call your local office to avoid overpayments.
If you earn above the SSI limit, your payments may stop. But you can keep Medicaid in some cases, and Social Security has rules to help you get benefits back if your income drops.
Yes, children with Prader-Willi Syndrome may qualify for SSI if their condition severely limits daily activities. They may also get benefits as a dependent on a parent’s record.
