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SR: Certain SSI recipients and former recipients are eligible for continued SR coverage even if their earnings appear to make them over-income. These customers may be covered under 1619(a), 1619(b), Plans to Achieve Self-Sufficiency (PASS), and other relevant provisions of the Social Security Act. If a customer formerly received SSI, even in the distant past, and now appear over-income for SR due to earnings, please contact the Policy Unit for guidance.

QM: See SR above. Former SSI beneficiaries may actually be eligible for continued SR coverage if they lost SSI because of increased earnings. These new or recertifying customers often appear to be (a) ineligible for SR but (b) eligible for QM due to the increase in earnings. In addition, this group includes customers who may have stopped receiving SSI in the past and may until now have appeared to be SR eligible. Please contact the Policy Unit for guidance.

Example Mr. Gomez applies for SR Medicaid but appears to be over-income due to earnings. The SSR notes that Mr. Gomez received SSI between 1992 and 1999 and promptly contacts the Policy Unit for guidance. With assistance from the Policy Unit, the SSR directs Mr. Gomez to complete several forms; after doing so, Mr. Gomez becomes automatically entitled to Medicaid coverage. Example Ms. Jackson recertifies for SR Medicaid but appears to be over-income because of earnings. The SSR notes that Ms. Jackson received SSI until recently; her SSI termination actually generated the recertification notice. The SSR contacts the Policy Unit for guidance; with assistance from the Policy Unit staff, the SSR directs Mr. Gomez to complete several forms; after doing so, Mr. Gomez becomes automatically entitled to Medicaid coverage.

50-64 DEMONSTRATION 1.16

AR: N/A AX: N/A SR: N/A QM: N/A MC: Note: This program ended effective July 1, 2010. These persons are now eligible under the Childless Adult group for Medicaid (See “Childless Adults” under Section 2.2.1: MA Program Eligibility Criteria in Part I.) . This section is left here for historical purposes.

This special Demonstration program provides Medicaid benefits to customers age 50-64. These customers must have income and resources below the Medically Needy income limits, and they must meet all other criteria for Medicaid (e.g., citizenship/alienage, SSN, District residency, etc.) except disability.

However, application for the 50-64 Demonstration was suspended on November 5, 2003. These customers are enrolled in the MC program type in ACEDS and use the 370 program code.