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Effective: December 1, 2013 |
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03.30.15ar5 - Medical Assistance (MA) for People With a Disability (Archive) |
Archived: March 1, 2014 |
People who are certified as disabled by the Social Security Administration (SSA) A federal agency which administers the SSI, RSDI and Medicare programs. or State Medical Review Team (SMRT) A unit at DHS that determines disability in consultation with medical professionals appointed by the commissioner. have a basis of eligibility for MA. There is no age limit for this basis.
Eligibility factors and links to standard program guidelines are provided below.
Citizenship/Immigration Status.
Insurance and Benefit Recovery.
Relationship to Other Groups/Bases.
Application Process (standard guidelines)
Process MA applications within 60 days for people whose eligibility is based on disability.
Follow standard MA guidelines.
Follow standard MA guidelines.
Disability must be verified through a certification from SSA or SMRT. See Certification of Disability.
Some people with disabilities may lose their RSDI benefits because their earnings exceed the Substantial Gainful Activity (SGA) A level of work activity and earnings, defined by the Social Security Administration. level. These people may qualify for continued Medicare coverage for up to 93 months after their RSDI benefit ends. If they continue to have a disabling impairment, SSA continues to consider them disabled and eligible for Medicare, and they therefore meet a disabled basis of eligibility for MA.
Social Security Number (standard guidelines)
Follow standard MA guidelines.
Follow standard MA guidelines.
See the Medical Assistance Immigration Status and Eligibility Table for a summary of MA system coding for noncitizens with a disability.
Follow standard MA guidelines.
Follow standard MA guidelines.
Household Composition (standard guidelines)
Use a household size of one and do not count parents' income as available to a child of any age who receives Supplemental Security Income (SSI) A program based on financial need operated by the Social Security Administration that provides monthly income to low income people who are age 65 or older, blind or disabled..
For an 18 through 20-year-old child using a disabled basis of eligibility use a household size of:
l One for a child who lives in the parental home. Do not deem parental income.
l Two for a child who is married and lives with their spouse. Deem spousal income.
l Two or more if the disabled child has children living in the home.
Use Method B for income and assets.
Asset Guidelines (standard guidelines)
The asset limit is:
l $3,000 for a household of one.
l $6,000 for a household of two.
l $200 for each additional household member.
Note: There is no asset limit for children under 21, regardless of their basis of eligibility.
The income limit is 100% FPG.
Deductions/Disregards (standard guidelines)
Use the applicable Method B deductions in the order given:
1. Disabled widow and widower’s disregard.
2. Widow and widower's disregard.
3. Pickle disregard.
4. Disabled adult children disregard.
5. Income used to fulfill an approved Plan to Achieve Self Support (PASS) for disabled or blind people.
6. Earned income disregard for blind or disabled student children.
7. The first $65 of earned income disregard.
8. Work expense deduction for disabled clients.
9. One-half the remaining earned income.
See Elderly, Disabled and Blind Income Computation Worksheet (Method B) (DHS-0029C).
Spenddowns (standard guidelines)
People with incomes over 100% FPG may be eligible by spending down to 75% FPG.
Follow standard MA guidelines.
People who are not enrolled in a managed care plan receive services through fee-for-service A method of payment for health services. The medical provider bills the insurer and is paid for specific individual services. (FFS).
People under age 65 who are eligible for MA due to blindness as determined by the Social Security Administration (SSA) or the State Medical Review Team (SMRT) are excluded from mandatory managed care enrollment. However, people may voluntarily enroll in Special Needs BasicCare (SNBC) if they are:
l Ages 18-64 and are eligible for MA with or without Medicare Parts A and B.
l Certified disabled by SSA or SMRT.
l Reside in any Minnesota county except Cook, Itasca, Kittson, Lake of the Woods, Marshall, Pennington, Red Lake, Roseau or Swift.
Note: Personal care attendant (PCA) and private duty nursing (PDN) services continue to be paid through fee-for-service (FFS).
Some adults without children who are certified disabled and who apply for MinnesotaCare may be required to apply for MA. See Disabled Adults Without Children.
Follow standard MA guidelines. See Change in Basis of Eligibility and Changes in Circumstances.
People whose eligibility is based on disability must use a Method B basis of eligibility for the Medicare Savings Programs, regardless of which MA method they choose.
People whose eligibility is based on disability may also be eligible for:
l The Medicare Savings Programs if they are Medicare-eligible.
l A waiver of deeming requirements and/or expanded MA services.
Children who are certified disabled may also be eligible as children under 21. See Multiple Bases of Eligibility.
Some disabled children who lost their SSI eligibility under the Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA) Federal law signed on August 22, 1996 which eliminated the federal entitlement program AFDC and created a new program called Temporary Assistance for Needy Families (TANF). PRWORA provides block grants to states to offer time-limited cash assistance. It also made major changes in the Food Support Program and delinked eligibility for Medicaid from receipt of cash assistance. may be eligible for MA under a special category.