Procedures

Follow the steps below to process the Medicaid application of a sponsored alien.

Step 1 Verify the alien’s SSI application was denied based on the sponsor’s income or resources. If the A/R is denied SSI solely due to the sponsor’s deemed income or resources, consider eligibility for Medicaid under any class of assistance, including SSI Medicaid. Step 2 Determine eligibility for Medicaid without considering the income and resources of the sponsor. Consider retroactive and ongoing eligibility. A reduction in the income and resources of the sponsor, the sponsor’s spouse or the A/R may make the A/R eligible for SSI. Remind the A/R and sponsor to report changes in financial circumstances. Step 3 Verify the month SSI will stop counting the income and resources of the sponsor. Step 4 Complete the CMD at least one month before the month SSI will stop counting the income and resources of the sponsor to determine if the alien is SSI eligible or eligible under a COA other than SSI Medicaid. Refer to 2052 Continuing Medicaid Determination . Step 5 Obtain DMA Form 526 or a written, signed statement from the physician verifying the need for emergency medical services. The signature should be the original signature of the physician or a medically trained employee of the physician designated to act on his/her behalf. Forms using the physician’s stamped signature are not acceptable. Faxes are acceptable if the form is faxed from the physician’s office and the signature on the faxed form was original. When questionable, contact the physician’s office to verify.