Prior Month for SSI Applicants

Effective for all SSI applications filed on or after August 22, 1996, Social Security will not issue an SSI check for an eligible individual for the month of SSI application. The first month an SSI payment is made is the first month following the month of application, or the first month following the month that the individual becomes eligible for SSI with respect to that application, whichever is later.

The SSI status for the first month of payment is C01; the SSI status for the preceding month is E02. However, the E02 month is not an automatically Medicaid eligible month in DCH’s system unless it is followed by a month in pay status (C01). In those instances, treat the E02 month as a prior month.

The first month of SSI payment is not relevant to prior month(s) eligibility. The three months prior for an approved or denied SSI application are the three months prior to the month of SSI application.

Determine eligibility under any Medicaid COA for the first and/or second month(s) prior to the month of an approved SSI application.

Determine eligibility for the third month prior to the month of an approved SSI application under any Medicaid COA except SSI Medicaid.

EXAMPLE: If the SSI application month is January, the first prior month is December, the second prior month is November, and the third prior month is October.

Determine eligibility under any COA for the three months prior to an SSI denial.

Do not determine Medicaid eligibility for any month prior to a SSI application until SSA has completed its determination. Once SSA has made the determination, determine eligibility for the three months prior using the procedures outlined in this section. Abide by decisions made by SSA for intervening months except when Medicaid policy for a particular COA differs from SSI policy.

Determine retroactive ABD Medicaid eligibility through the month of death for the following individuals:

An individual who dies prior to applying for SSI

An individual who dies after applying for SSI

SSA will complete the SSI application process for a deceased individual only if s/he has a surviving spouse. If SSI is approved, SSI will be awarded for the month following the month of application through the month of the A/R’s death.