Procedures

Follow the steps below to determine Medicaid eligibility under the Disabled Adult Child COA.

Step 1 Accept the A/R’s Medicaid application. Step 2 Conduct an interview. Step 3 Obtain verification from SSA to verify the following: The date SSI benefits were terminated. The current amount of the A/R’s RSDI disabled adult child benefit. The amounts of the RSDI initial entitlement, increase or COLA that caused SSI termination and all RSDI increases received since SSI was terminated. Step 4 Determine all basic eligibility criteria except LOS and LOC. Refer to Chapter 2200, Basic Eligibility Criteria. Step 5 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 and resource limit (individual or couple) to use Which eligibility budget to complete. Step 6 Determine the A/R’s countable income by disregarding the following amounts of RSDI income: The initial entitlement to or increase in RSDI as a disabled adult child or an increase in RSDI income that caused SSI termination OR The RSDI disabled adult child COLA that caused SSI termination AND All subsequent increases in RSDI. This would include COLAs as well as RSDI increases due to a change in the parents' circumstances, such as retirement and/or death. The only RSDI increase that would not be subject to disregard would be an increase due to the DAC’s own work record. Step 7 The RSDI claim number will end with a beneficiary identification code (BIC) that includes C if the A/R receives RSDI as a disabled adult child. Approve Medicaid on the system using the Disabled Adult child COA if the A/R meets all the above eligibility criteria, including retroactive months if needed. Do not approve Medicaid using the Disabled Adult Child COA for any month for which the A/R was eligible for and received an SSI payment.