410-7 INITIAL MONTH BENEFITS

410-7 INITIAL MONTH BENEFITS

The benefit start date for APA and Medicaid benefits may vary as follows:

410-7 A. INITIAL MONTH’S APA PAYMENT

1. Applicant meets all eligibility requirements on date of application

For applicants who meet all APA eligibility requirements (including receipt of SSI benefits) on the date of application, the benefit start date will begin the date the APA application is received in a DPA office.

2. Applicant is not eligible for SSI payment or needs a disability determination at time of application

For applicants who are not receiving SSI or those who need a disability determination, the APA benefit start date will be the first day of the month after Social Security Administration awards SSI or SSDI benefits, or the first day of the month after the Disability Determination Service ( DDS ) notifies DPA that the applicant is disabled, whichever is earlier.

If the applicant does not provide a copy of the Social Security award letter, eligibility staff can verify the award date with Social Security Administration. This can be done by contacting Social Security Administration directly or by utilizing the electronic interfaces.

Note: If there is conflicting or questionable information on the interfaces, eligibility staff must request a copy of the award letter from the applicant or verify the award information with Social Security Administration.

Example: On January 5, an individual applies for APA . The application is pended for 30 days for the individual to be in pay status with SSI benefits. On January 31 the SSA issues a notice to the individual that they are eligible for SSI beginning February 1. Because the SSA notified the individual of SSI eligibility in January, the benefit start date for APA is February 1.

410-7 B. INITIAL MONTH’S APA PAYMENT FOR INTERIM ASSISTANCE RECIPIENTS

Interim Assistance recipients who are approved for SSI are eligible for APA benefits beginning with the 1st day of the month after the month SSA decides the individual is eligible for SSI . (Refer to section 426-7A .)

410-7 C. ELIGIBILITY FOR MEDICAID

If otherwise eligible, APA applicants may qualify for Medicaid coverage back to the month that an APA application is received. There are some APA policies that do not apply to Medicaid. For example, development of income requirements do not apply to Medicaid. To qualify for Aged, or disability related Medicaid, an individual must still meet all other factors of eligibility including blindness, disability or age. When an APA applicant doesn't meet all factors of eligibility for Aged, or disability related Medicaid, the caseworker must always determine if an individual is eligible for another category of Medicaid such as MAGI Expansion Medicaid. See MAGI Medicaid Manual Section 816 .

Example: An applicant applies for APA and related Medicaid on September 30, 2025. The individual is 35 years of age, has no income, no disability determination, and is not in pay with SSI . The individual's APA application must be pended for the individual to apply for and be in pay with Supplemental Security Income (SSI). The caseworker determines that the individual is eligible for Medicaid in the MAGI Expansion category the month the application is received.

Note: Effective October 1, 2026, individuals must meet Medicaid qualified alien requirements for Medicaid. Refer to ADLTC MS 522 and MAGI MS 808 for policy on U.S. citizenship and eligible alien status.

410-7 D. RETROACTIVE MEDICAID COVERAGE

An APA applicant may be eligible for Medicaid benefits for one or more of the three months before the month that the APA application was filed. Eligibility for Medicaid under this provision is explained in MAGI Medicaid manual section 827 .