Page 11

COMAR 10.09.24.12

1210 State of Maryland Medical Assistance Manual Revised July 2012 Children under 21 years of age cannot be placed on the “S98” medical coverage group, because CARES will not generate the correct application for redetermination. Therefore, the following procedures are to be applied:

Add-A-Program to the MA S02 for the child. The child will be the “SE” and the only member of the AU. Select MA type “F” and coverage group “F05” for 19 and 20 year olds. Select MA type “P” and coverage group “P06” for children under 19 years of age, so CARES will trickle to the appropriate coverage group. Use the current date as the application date. Go through the interview option.

o During the interview option, close the associated S02 on a “507” code, with the “paid through date” as of the end of the current month, to prevent dual participation. o On the “DEM2” screen, indicate “N” in the deprivation field for the child. o Delete SSI income from the “UINC” screen for the ongoing month. If other income is present, it should also be deleted. o At the bottom of the “UINC” screen, indicate “SI” for “Appl Type”, “T” for the status and the termination date from the SDX on-line inquiry. o When eligibility is confirmed on the “MAFI” screen for the S02, press PF-13 to add free-form text to the S02, closing notice, indicating that MA coverage will continue for at least 90 days in a different Medicaid Coverage group. o When processing the application month, on the “STAT” screen use “NM” as the financial responsibility reason code for the child in order to avoid dual participation edits. Do not close the associated S02 case when processing the application month. o Finalize the Au. On the “MAFI” screen, set the “Redet End Date” for three months from the current month finalized in April. The “Redet End Date” should be entered as 07/02 on the “MAFI” screen.

(3) Disabled Adult Children (DAC)

A person who is at least 18 years old, who began receiving SSI benefits on the basis of blindness or disability and whose disability occurred before the age of 22, is referred to as a Disabled Adult Child (DAC). When one of these individuals begin receiving Social Security benefits, based on a parent‟s account who has become aged, disabled, or deceased, the SSA benefit, generally greater than the SSI benefit, results in the DAC‟s loss of SSI eligibility. Although the DAC no longer receives SSI payment he/she is deemed eligible for continued Medical Assistance benefits as a SSI recipient. In the event that SSA does not accurately transmit this information; the individual must be certified as a Medical Assistance recipient. This information is reflected on