Printer-Friendly Version
Email This Article
Special Medicaid Beneficiaries - January 2010
Introduction
In most states, categorical Medicaid eligibility for the aged, blind and disabled is directly tied to receipt of SSI benefits. For this reason, loss of SSI benefits often results in loss of Medicaid coverage. Over the years, Congress has enacted special Medicaid continuation provisions to preserve critical Medicaid coverage for certain special groups of individuals who lose eligibility for SSI. For the purposes of this paper, a “special Medicaid beneficiary” is someone who lost SSI payments due to establishing eligibility for or receiving increases in title II disability benefits (SSDI, CDB, DWB), but who meets specific criteria which allows Medicaid coverage to continue.
Types of Special Medicaid Benefits
The types of special Medicaid beneficiaries that CWICs could encounter are individuals who lost SSI eligibility because of:
1. Any reason, but who are not currently entitled to SSI because of Cost-of-Living Allowances (COLAs) in Social Security Disability Insurance (SSDI);
2. Entitlement to or increase in Childhood Disability Benefits (CDB); or
3. Entitlement to Disabled Widow(er)s Benefit (DWB) until Medicare starts.
When determining Medicaid eligibility for these special former SSI recipients, State Medicaid agencies must exclude that portion of the eligible individual’s title II disability benefit that caused the loss of SSI payments. Essentially, if the individual would otherwise be entitled to SSI or 1619(b) if those increases did not exist, that individual would be entitled to Medicaid under these special provisions. Let’s take a look at each of the three different types of special Medicaid beneficiaries individually.
Have a Question or Comment About This Article?
