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Louisiana Medicaid Eligibility Manual Eligibility Factors

Issued April 18, 2022

Page 1 of H-700 Replacing November 1, 2000

Deleted text indicated by “**” Revised/added text indicated by underscore

H-700 SSI RETROACTIVE MEDICAID

H-710 GENERAL INFORMATION Applicants for Supplemental Security Income (SSI) are asked by Social Security Administration (SSA) at the time of the application interview if they have unpaid medical bills incurred during the three months prior to the month of application. The response to this is indicated on the SSA interface information for both SSI certifications and rejections by "Y" (yes) and "N" (no).

Explore SSI Retroactive Medicaid for those applicants who indicate unpaid medical bills ("Y" indicator), whether the SSI application is approved or denied.

This program will provide retroactive Medicaid coverage to applicants/beneficiaries with income below the Federal Benefit Rate (FBR) and resources that meet SSI limits. ** If the applicant/beneficiary is not eligible for SSI in the retroactive period, explore current eligibility in all other Medicaid programs. A disability determination may be made by Medicaid’s Medical Eligibility Determination Team (MEDT) without having an SSI determination made by the SSA.

Refer to Retroactive Medical Eligibility (RME) MEM H-1800 for more information.

H-711 NOTIFICATION OF APPLICANTS/BENEFICIARIES FOR SSI

** Upon the SSI approval or denial interface indicating that retroactive coverage was requested, the applicant/beneficiary is notified of their right to request Medicaid coverage for the three months prior to SSI application.

H-712 REQUEST ** FOR RETROACTIVE COVERAGE

The individual has ** 90 days from the date of the notice to request this retroactive coverage period.

The SSI Retroactive Medicaid Eligibility determination is separate from the determination for current and on-going eligibility, but the same application form is used.