2.3.7 Medical Assistance 1619(a) or 1619(b)

Supplemental Security Income (SSI) is a federal program administered by the Social Security Administration (SSA) that provides monthly cash payments to people age 65 or older and people who are or certified blind or disabled and have little or no income.

SSI has a work incentive provision under section 1619 of the Social Security Act for people whose earnings reduce or eliminate their SSI cash benefit. People who are eligible for SSI under section 1619 are eligible for Medical Assistance (MA) without regard to their income or assets. 1619(a) is for people who receive a partial SSI cash benefit. 1619(b) is for people who no longer receive an SSI cash benefit and maintain their disability status.

The SSA determines 1619(a) and 1619(b) non-financial eligibility.

This page outlines the general, financial, non-financial, and post eligibility requirements for people under a 1619(a) or 1619(b) status. It describes policies that apply to MA-1619(a) and 1619(b) and links to policies that apply to all MA programs, MA for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD), and all Minnesota Health Care Programs (MHCP) programs.

1.  General Requirements

   1. MA Applications

   2. People currently enrolled in MA who gain 1619(a) or 1619 (b) status are not required to submit a new application to continue MA eligibility. People not currently enrolled in MA who gain 1619(a) or 1619(b) status must submit a new application to apply for MA. Refer to Section 1.2 Minnesota Health Care Programs (MHCP) Applications for more information about applications.

   3. MA Responsibilities

      1. MA Benefit Recovery

         1. MA Estate Recovery

         2. MA Liens

         3. MA Third Party Liability

         4. MA Cost Effective Insurance

         5. MA Medical Support

         6. MA Other Third Party Liability

      2. MA Cooperation

      3. MA Cost Sharing

      4. MHCP Fraud

      5. MHCP Inconsistent Information

      6. MA Referral for Other Benefits

   4. MHCP Rights

      1. MHCP Appeals

      2. MHCP Authorized Representative

      3. MHCP Civil Rights

      4. MHCP Data Privacy

      5. MHCP Notices

2. Non-Financial Eligibility

   1. The person's 1619(a) or 1619(b) status must be verified at application and renewal.

3. MA-ABD Non-Financial Eligibility

• Financial Eligibility

  1. SSI beneficiaries who received Medical Assistance (MA) the month before the initial month they were certified for special SSI status under sections 1619(a) and 1619(b) of the Social Security Act are eligible for MA without regard to income or assets. SSA makes determinations and redeterminations of a person’s 1619 (a) or 1619 (b) status.

  2. Verification of income and assets are not required while the person remains under the 1619(a) or 1619(b) status.

  3. See the SSA Continued Medicaid Eligibility web page for more information.

• Post-Eligibility

  1. MA Benefit Recovery

     1. MA Estate Recovery

     2. MA Liens

     3. MHCP Overpayments

     4. MA Third Party Liability

     5. MA Cost-Effective Insurance

     6. MA Medical Support

     7. MA Other Third Party Liability

  2. MHCP Change in Circumstances

  3. MA Cooperation

  4. MA Cost Sharing

  5. MHCP Fraud

  6. MA-ABD Health Care Delivery

  7. MHCP Inconsistent Information

  8. MA Qualifying Health Coverage

  9. MA Referral for Other Benefits

  10. MA-ABD Renewals

DHS pays Medicare Part B premiums for 1619(a) and 1619(b) recipients enrolled in Medicare and receiving Retirement, Survivors, or Disability Insurance (RSDI) benefits.

Legal Citations

Minnesota Statutes, section 256B.056, subdivision 1a

Social Security Act, section 1619

Published: June 1, 2022

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