Special Status MA
What are the 3 categories of Special Status Medicaid?
DAC, 503 & Widow/Widower
What are the eligibility categories for an individual who qualified for DAC?
MP D and NP D
Fill in the blank: To be considered a 503 group, a person must receive SSI income in the month ________ to the month in which they began to receive the Social Security payment.
Prior
List 3 types of eligibility that are considered Group A?
MS, NS, NS met deductible, MPC, MPD, NPC, NPD, MAPP, MAGS, SSI, KBM, Adoption Assistance MA, Foster Care MA, WI Well Women MA
What group includes working people with earnings at or above the substantial gainful activity level who continue to receive a small SSI check or no longer receive SSI benefits due to earned income?
1619
What is the income limit for all Special Status Medicaid?
The assistance group must have countable income at or below 100% FPL after "special status" Social Security disregards.
What does DAC stand for?
Disabled Adult Child
What are the eligibility categories for an individual who is 503 eligibility?
MP C and NP C
If a member qualifies for Group A eligibility and in enrolling in waivers, do they need a Community Waiver screen?
No
In order to qualify for Widow/Widower group, the member can not be entitled to what?
Medicare A
What 3 occasions does Special Status Medicaid need to be evaluated?
Application, Renewal and loss of SSI MA.
What type of SSA benefit does a DAC individual receive?
SSDC/Social Security Disabled Child
What type of income is disregarded in 503 eligibility?
COLA
What is the processing work around for an application for Children's Waivers when there are other members in the HH requesting Healthcare?
Updated the benefits received 1619b to Yes.
When determining the special status disregard amount for a former 1619 participant who lost Medicaid eligibility due to receiving SSA benefits, instead of the date that SSI ended, what is the date used?
The date they lost SSI MA.
What CWW page is Special Status MA determined?
Prior SSI
The two components to identify someone who qualifies as a DAC for Medicaid purposes are:
1. They currently receive a Social Security disabled child payment and
2. ?
They previously received SSI (or they were a 1619b participant), but they became ineligible for SSI/1619b due to excess income when they started receiving or had an increase in SSDC benefits.
If someone has their SSI end in the current year, what would be their COLA disregard?
$0
What is the work around used in CWW that prevents a member from opening for MAGC and MCWK if they are the only member of the household requesting healthcare?
Updating TFI to failed to provide.
If someone lost SSI due to receiving SSDW/SSWW, but who do not qualify for Widow/Widower disregard because they receive Medicare, may be eligible for what other category of SSI MA?
503
What is the asset limit for an unmarried person for Special Status MA? For a Married Couple?
Countable assets at or below $2,000 for unmarried. $3,000 for married couple.
What is the difference in calculating the disregard is someone lost SSI due to the initial payment vs. and increase in SSDC?
For the initial payment, the gross amount of the SSDC payment is disregarded. For an increase, you subtract the gross SSDC payment amount immediately prior to the increase the cause the loss of SSI. Subtract this amount from the current gross SSDC amount. The difference is the disregard.
What three elements qualifies someone as 503 elibigible?
1. They currently receives some type of SSA benefit.
2. They were previously eligible for SSI but became ineligible for SSI/1619b for any reason and
3. They were eligible for SSI/1619b benefits concurrently with SSA benefits.
What actions should you take if someone becomes Group A eligibility and are open for waivers in CWW?
Updated the community waiver page to no, close the waiver eligibility and send a manual letter following PH 12.18.2.3.3.
When Medicaid eligibility is determined for someone who meets Widow/Widower criteria, how much of the SSDW/SSWW is disregarded?
The entire SSDW/SSWW payment