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4 TITLE 16 HEALTH AND SAFETY DELAWARE ADMINISTRATIVE CODE

case worker receives asset information after a renewal has been completed, the receipt of new information will be treated as a change in circumstances. See Section 14820 Changes in Circumstances. 29 DE Reg. 604 (01/01/26)

17160 Adult Children with Disabilities Section 1634(c) of the Social Security Act states:

"(c) If any individual who has attained the age of 18 and is receiving benefits under this title on the basis of blindness or a disability which began before he or she attained the age of 22--

·becomes entitled, on or after the effective date of this subsection, to child's insurance benefits which are payable under section 202(d) on the basis of such disability or to an increase in the amount of the child's insurance benefits which are so payable, and

·ceases to be eligible for benefits under this title because of such child's insurance benefits or because of the increase in such child's insurance benefits,

·such individual shall be treated for purposes of title XIX as receiving benefits under this title so long as he or she would be eligible for benefits under this title in the absence of such child's insurance benefits or such increase."

The policy allows for certain former recipients of Supplemental Security Income (SSI) to continue to receive Medicaid after their SSI benefits have terminated. 15 DE Reg. 202 (08/01/11)

17160.1 Eligibility Determination To be eligible the individual must meet all the following criteria: ·be age 18 or older, ·have been receiving SSI, ·lost their SSI benefit because they started to receive Child's Insurance Benefits after 7/1/87 or ·received an increase in Child's Insurance Benefit after 7/1/87. Child's Insurance Benefit is a type of Title II Social Security benefit as defined below: A child is entitled to Child's Insurance Benefits on the Social Security record of a parent if: 1. an application for Child's Insurance Benefit is filed, and 2. the child is (or was) dependent upon the parent, and 3. the child is unmarried, and 4. the child is: under age 18, or under age 19 and a full-time elementary or secondary school student, or age 18 or over and under a disability (which must have begun before age 22) and 5. the parent: is entitled to disability insurance benefits, or is entitled to retirement insurance benefits, or died and was either fully or currently insured at the time of death. Determine eligibility using SSI income and resource standards and methodologies. The Child’s Insurance Benefit is excluded from income. Redeterminations are completed annually. The resource test will be waived at annual renewal. If the case worker receives asset information after a renewal has been completed, the receipt of new information will be treated as a change in circumstances. See Section 14820 Changes in Circumstances. 22 DE Reg. 859 (04/01/19) 29 DE Reg. 604 (01/01/26)

17170 Section 4913 Children with Disabilities Section 4913 of the Balanced Budget Act (BBA) provides that children who were receiving SSI payments on August 22, 1996, and who but for the enactment of the new disability definition under § 211(a) of the Personal Responsibility and Work Opportunity Act of 1996 (PRWORA), would continue to be paid SSI, are mandatory categorically eligible for Medicaid. This provision is effective for those children who lose their SSI payment on or after July 1, 1997. 15 DE Reg. 202 (08/01/11)

17170.1 Technical Eligibility The child must meet all of the following requirements: (a)The child was being paid SSI on August 22, 1996. This includes children who, as of August 22, 1996, were in current pay status, had received favorable or partially favorable administrative decisions, or had a Zebley appeal pending. (b)The child's SSI payment stopped on or after July 1, 1997. (c)The decision to stop SSI payments was due to a determination that the child does not met the definition of disability enacted on August 22, 1996, at § 211(a) of the Personal Responsibility and Work Opportunity Act of 1996. (d)The child would, except for the disability determination described in (c), continue to be paid SSI.