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Effective: December 1, 2006 |
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03.30.30ar1 - Medical Assistance (MA) for 1619(a) and 1619(b) (Archive) |
Archived: August 1, 2008 |
Employed disabled people who received Medical Assistance (MA) the month before the initial month they were certified for special Supplemental Security Income (SSI) status under sections 1619(a) and 1619(b) of the Social Security Act are eligible for MA without regard to income or assets.
For information about how the Social Security Administration (SSA) determines 1619(a) and 1619(b) status, see Supplemental Security Income (SSI).
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)
Follow the disabled guidelines.
Follow standard MA guidelines.
People with 1619(a) or 1619(b) status are exempt from six-month renewals.
Verifications (standard guidelines)
Verify 1619(a) or 1619(b) certification with the Social Security Administration (SSA).
Follow standard MA guidelines.
Follow standard guidelines for federally funded MA.
Residency (standard guidelines)
Follow standard MA guidelines.
People who are age 65 or older, have 1619(a) or 1619(b) status, and receive only SSI benefits should be referred to Medicare for voluntary enrollment in Parts A and B, and then enrolled in the Qualified Medicare Beneficiary (QMB) program.
People with 1619(a) or 1619(b) status who receive Retirement, Survivors, and Disability Insurance (RSDI) benefits and are enrolled in Medicare are automatically accreted to the buy-in, so have no need for Medicare Savings Program eligibility.
Not applicable - there is no income or asset test, so household composition (deeming and household size) is not an eligibility factor.
Eligibility Method (standard guidelines)
Not applicable - there is no income or asset test, so no evaluation method is needed.
Not applicable; people remain eligible without an asset test as long as they retain 1619(a) or 1619(b) status.
Not applicable; people remain eligible without an income test as long as they retain 1619 (a) or (b) status.
Deductions/Disregards (standard guidelines)
Not applicable; people remain eligible without an income test as long as they retain 1619 (a) or (b) status.
Not applicable; people remain eligible without an income test as long as they retain 1619 (a) or (b) status.
Follow standard MA guidelines.
Follow the disabled guidelines.
If people lose 1619(a) or 1619(b) status and then regain it, determine if they were receiving MA the month before the original certification.
Example:
Joe is certified disabled by the Social Security Administration (SSA) and received MA and SSI. He became employed in June 2005 and was given 1619 status in July 2005.
Action:
Continue Joe's MA eligibility because he was receiving MA in June, the month before he was certified for 1619 status.
Note: If Joe later loses 1619 status, he will lose automatic MA eligibility. However, if he is recertified at a later date, he will regain automatic MA effective the month the 1619 status is regained.
If people lose this status, they must meet all MA eligibility requirements, including those for income and assets, under another basis of eligibility.
See Insurance and Benefit Recovery above for information about people with 1619(a) or 1619(b) status and the Medicare Savings Programs.