Procedures

Follow the steps below to determine Medicaid eligibility under the SSI Medicaid COA.

Step 1 Accept the A/R’s request for retroactive Medicaid. A signed application is not required for this COA since an application has been filed with the Social Security Administration (SSA). Step 2 Obtain information necessary to process the requested months of eligibility. Step 3 Determine basic eligibility criteria. Refer to Chapter 2200, Basic Eligibility Criteria. Step 4 Determine financial eligibility using the current SSI income and resource limits. Refer to Chapter 2500, ABD Financial Responsibility and Budgeting, to determine the following: Whose income and resources to consider Which SSI income/resource limits (individual or couple) to use Which eligibility budget to complete. Step 5 Approve Medicaid using the SSI Medicaid COA for any retroactive month in which the A/R meets all eligibility criteria. Do not approve SSI COA for the third month prior to an SSI approval. Refer to 2053 Retroactive Medicaid for the appropriate COA and procedures on completing prior months for SSI applications.