Adult Medicaid Manual MA-1000 SSI MEDICAID AUTOMATED PROCESS

II. POLICY PRINCIPLES FOR SSI MEDICAID

A. SSI recipients are eligible for Medicaid based on receipt of SSI.

B. Ongoing Medicaid eligibility is determined by the Social Security Administration (SSA) for SSI recipients.

C. EIS automatically issues Medicaid benefits and notices to SSI recipients based on receipt of SSI.

REVISED 10/1/05 - CHANGE NO.29-05

(II.)

D. The county dss evaluates Medicaid eligibility for SSI recipients when the SSI benefit terminates. The county dss must explore and exhaust all possible avenues of eligibility in other aid program/categories.

When the SSI termination is based on no longer being disabled and the SSI recipient timely appeals the SSI decision, his disability status continues through the SSI appeals process. Continue Medicaid benefits as long as he meets non-disability criteria through the SSA appeal process. Refer to MA-2525, Disability, for timeframes on appeals.

Refer to VII.D., Continuation of MAD When SSI Disability Termination is in Appeal Status for ex parte procedures. The recipient also has the right to appeal to a State Hearing Officer on the issue of disability if the ex parte process finds him no longer eligible for Medicaid.

If the recipient has a non-disability SSI change that results in ineligibility, he may continue to be eligible as MAD or cease to be eligible as MAD. The county dss must explore and exhaust all possible avenues of eligibility in other aid program/categories.