1610.02.00 SSI ELIGIBLE INDIVIDUALS (MED 1)

This category is identified in the eligibility system as MASI. To be eligible for MASI Medicaid, an individual must be determined to be disabled by the Social Security Administration. When determined SSI disabled and receiving SSI payments, the proper category of assistance is MASI. MASI is based on categorical eligibility and does not have a budget or redetermination. It is a full coverage category with no cost sharing and is at the top of the Medicaid hierarchy, therefore, it should not be replaced with any other category of medical coverage. MASI should be given only based on information received via SDX Interface from the Social Security Administration. The SDX Payment Information page displays the detailed payment status codes for MASI budgeting. The "Payment status code" indicates if an individual is receiving any dollar amount (SSI benefits) and the "Medicaid Eligibility Code" indicates if the SSI applicant is eligible for Federally administered Medicaid coverage (MASI). There are several codes received from SSA via SDX interface, however only one will form SSI. Please see below for detailed information: This population receives SSI payments: • Federally administered Medicaid coverage should be continued regardless of payment status code (1619(b) participants) • This population may or may not be receiving SSI payments: • Goldberg/Kelly payment continuation • Eligible for Medicaid (N24 Payment Status Only) • Eligible for Medicaid (1634 States Only) • All the remaining listed codes are not eligible for MASI budgeting: • REFUSED TO ASSIGN RIGHTS TO TPL • DEEMING WAIVED, CHILD UNDER A STATE HOME CARE PLAN • REFERRED TO THE STATE FOR MEDICAID DETERMINATION DUE TO ENTITLEMENT OR INCREASE IN DAC BENEFITS UNDER T2 • ELIGIBLE UNDER STATE DETERMINATION (OBSOLETE) • TITLE VIII SPECIAL VETERANS BENEFIT RECEIPIENT • INELIGIBLE PER STATE DETERMINATION (OBSOLETE) • DRUG ADDICITON AND/OR ALCOHOLISM (OBSOLETE) • MEDICAID QUALIFYING TRUST MAY EXIST • REFERRED TO STATE FOR DETERMINATION (1634 STATES) - FEDERAL DETERMINATION NOT POSSIBLE • STATE DETERMINATION - NOT SSA RESPONSIBILITY • WIDOW(ER) - 1634 STATES If the worker questions whether MASI is the correct category, they should contact Helpdesk/PAL rather than open MASI without the correct SSA determination. If a person has deemed SSI eligibility but is not receiving payments because another SSA benefit amount is more than the maximum SSI amount (such as disabled adult children members), these members should be determined for MED 1 eligibility under normal income and resource rules. The maximum SSI payment amount should be entered into as SSI income, and any excess above that amount should be entered as Social Security income. This will cause the income to be properly counted in the budget for all programs. This would apply to some widow/ers (see 2414.10.20) and Disabled Adult Children (see 2414.10.10).