Procedures

Follow the steps below to determine Medicaid eligibility under the Disabled Widow(er) COA:

Step 1 Accept the A/R’s Medicaid application. Step 2 Obtain information required to complete the eligibility determination. Step 3 Obtain the following verification from the Social Security Administration: The date SSI/MSS benefits were terminated The current amount of the A/R’s RSDI Disabled Widow(er) benefit The amounts of the RSDI initial entitlement that caused SSI/MSS termination and all COLAs received since SSI/MSS was terminated The A/R’s current ineligibility for Medicare Part A coverage 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 Determine the A/R’s countable income by disregarding the following amounts of RSDI income: The initial entitlement to RSDI as a disabled widow(er) that caused SSI termination AND All subsequent COLAs The RSDI claim number will end with a beneficiary identification code (BIC) that includes “W” if the A/R receives RSDI as a disabled widow(er) or surviving divorced spouse. Step 6 Approve Medicaid under the Disabled Widow(er) COA if the A/R meets all the above eligibility criteria, including retroactive months if needed. Do NOT approve Medicaid using the Disabled Widow(er) COA for any month for which the A/R was eligible for and received an SSI payment. Step 7 Terminate Medicaid under this COA as soon as the A/R becomes entitled to Medicare Part A. Complete a CMD. Refer to 2052 Continuing Medicaid Determination .