Supplemental Security Income recipients can keep receiving full benefits for up to the first three full months of a medical confinement if they need to maintain the home they will return to. Form SSA-186 documents that: page 1 is the recipient's statement of need, and page 2 is the physician's certification that the stay is expected to last no longer than 90 full consecutive days.
The physician providing medical treatment in the facility completes the page 2 Physician Statement. The recipient, the representative payee, or a knowledgeable source if the recipient is incapacitated and has no payee completes page 1.
Download the current version from the source each time; forms change without notice.
Temporary Institutionalization Statement to Maintain Household and Physician Certification
A form is listed only after its name and number were confirmed on the issuing agency’s or insurer’s own website, or in the form itself. Each entry links to that source. The list was last checked in October 2026. Forms and their requirements change without notice, so check the official page for the current version before you complete one.
Vero is not affiliated with, or endorsed by, the agencies and insurers listed here. Read our editorial policy.
SSA must receive the physician's certification, or it must be postmarked, by the earlier of the 90th day of the medical confinement or the day the recipient is released. The recipient's statement of need on page 1 has the same deadline. The day of admission is not counted toward the 90 days.
The physician providing treatment certifies in writing that the recipient's medical confinement is expected to last no longer than 90 full consecutive days. If the stay later runs longer than expected, SSA policy says temporary institutionalization eligibility already established generally continues, so the certification reflects the expectation at the time of signing.