Adult Medicaid Manual MA-2110 PASSALONG

V. WIDOW(ER)S (INCLUDING SOME UNMARRIED, DIVORCED SPOUSES) WHO LOST SSI IN 1984

A. Eligibility Requirements

1. Be disabled (or were determined disabled by SSA until age 65).

2. Have received SSI or SA benefits in December 1983 but lost eligibility in January 1984 due to a statutory elimination of an additional benefit reduction factor for widow(er)s before age 60 who were entitled to widow(er)s benefits based on disability since January 1984;

3. Would currently be eligible for SSI or SA except for the receipt of RSDI benefits.

4. If passalong eligibility is based on former receipt of SA, the individual must currently reside in an adult care home.

B. Identify Individuals Who Lost SSI Eligibility.

Applicants/recipients need not claim passalong status. However, many individuals may not be able to remember when or if they received SSI or Special Assistance. Fully investigate passalong eligibility in every case where the individual is otherwise over income for CN MAD because of income from Social Security. If the individual clearly states he has never received SSI or SA, then document in the record that there is no passalong eligibility.

Use the following resources to identify individuals who lost SSI or SA eligibility:

1. The RSDI Claim number suffix will be “D” or “W” if the a/r receives as a disabled widow(er)/surviving divorced spouse.

2. SDX - The Medicaid Eligibility Code field indicates the eligibility status of “W” for a widow(er).

3. For individuals receiving as a Disabled Widow(er) prior to January 1, 1995, verify status by the case record or through Social Security Administration.

C. Verify Disabled Widow (er)s Eligibility Factors.

1. The date SSI benefits were terminated (Will be January 1984.)

2. The current amount of the a/r’s RSDI Disabled Widow benefit.

REVISED 11/01/11 – CHANGE NO. 17-11

(V.)

D. If You Determine the Individual is Passalong Eligible, Disregard All the RSDI Income.

E. Compare Other Countable Earned and Unearned Income to the Current SSI or SA Income Limit. (Use the 1/3 Reduced Income Limit If Appropriate.)

1. If the countable income does not exceed the current SSI or SA income limit, determine eligibility excluding RSDI benefits. This person is eligible under Passalong.

2. If the countable income is above the current SSI or SA income limit, the individual is not entitled to passalong. DO NOT disregard the RSDI income. This person is ineligible under passalong. If ineligible, count the current RSDI income.

F. Documentation

Use DMA-5150, Documentation of Passalong Eligibility or Ineligibility, to document whether or not that the individual is passalong eligible. If eligible as passalong, code the individual as “PW” in the Individual Special Use field on the individual level in EIS. If you find an individual who is eligible for passalong due to loss of SA and who is currently residing in an adult care home, contact the EIS Unit for procedures to follow to put this person in EIS.

G. Redeterminations

At subsequent reviews, determine if the individual still qualifies as passalong. Evaluate the income of the recipient. If other income, along with disregarding the RSDI income, still results in ineligibility, the individual is no longer eligible as passalong. If ineligible, count the RSDI income.