Adult Medicaid Manual MA-2110 PASSALONG

REVISED 11/01/11 – CHANGE NO. 17-11

I. INTRODUCTION TO PASSALONG

To preserve Medicaid coverage for certain groups of individuals who lose SSI, Congress enacted special Medicaid eligibility provisions. These provisions require the State to continue to evaluate specified groups of former SSI and SA recipients under categorically needy criteria. Qualified individuals are eligible for a disregard of certain RSDI benefits. This is called passalong. Passalong only applies to PLA budgeting and to Step 1 of LTC budgeting.

There are four eligibility groups for passalong. They are the COLA passalong (Pickle Amendment Group), Disabled Widow(er)s, Early Widow(er)s and Disabled Adult Children (DAC). A former State/County Special Assistance recipient may also qualify for passalong in any of these four groups as long as he continues to reside in an adult care home, even if the individual never received SSI.

Once an individual is determined to be passalong eligible in one of the above groups, always consider that individual as passalong in subsequent redeterminations and applications unless one of the eligibility requirements for that passalong group changes. You must document passalong eligibility or ineligibility and the reason in the permanent case record. Use the DMA-5150 Documentation of Passalong Eligibility or Ineligibility. When evaluating for passalong eligibility, evaluate eligibility in all applicable passalong groups. For individuals receiving Social Security as widow(er)s or as Disabled Adult Children, evaluate under sections III., IV., or V. below (as applicable) before evaluating under II.