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COMAR 10.09.24.03

405 State of Maryland Medical Assistance Manual Revised July 2012

A Quick and Easy Method of Screening for Medicaid Eligibility under the Pickle Amendment Screening for Medicaid eligibility under the Pickle Amendment is quick and simple. The screening process will eliminate the great majority of those who are not eligible without the necessity of performing any mathematical calculations. For those who survive the initial screening and for whom mathematical calculations are required, the table below provides a simple formula for performing the necessary calculations.

The Screening Process is as Follows:

Step 1: Does the applicant receive Social Security benefits? If the answer is no, then the person cannot be Pickle eligible. If the answer is yes, go on to the next step.

Step 2: After April 1977, did the applicant receive SSI? If the answer is no, the person cannot be Pickle eligible. If the answer is “yes”, go on to step 3.

Step 3: CM should ask applicant, “When was the last month you received SSI?” Once month is provided CM should then verify State Verification and Exchange System (SVES) for ending date.

Step 4: Look up the month in which the person last received SSI in the following table. Find the percentage that applies to that month. Multiply the present amount of the applicants (and/or spouse‟s) Social Security benefits by the applicable percentage.

Example Mrs. Irma Gherkin received both Social Security and SSI checks in 1976-78. However, her SSI was terminated in March 1978 because she started receiving a private pension that, added to her Social Security benefits, raised her income to an amount above the 1978 SSI income limits. There have been gradual increases in her income since 1978. She now receives a Social Security benefit of $1,229 per month, which happens to be the average monthly benefit for retired workers. Her private pension is $275 a month, giving her a total of $1,504 monthly. In 2012, the income limit for SSI (taking into account a $20 general income disregard) is $718 for an individual. Thus, Mrs. Gherkin‟s income is over twice the SSI income limit, which her state has adopted as the Medicaid limit for persons who are aged, blind or disabled. You screen Mrs. Gherkin for Pickle eligibility as outlined above. Determining that the last month in which she received both Social Security and SSI was March 1978, you look up that time period in the

Following table and find the corresponding reduction factor (.273).

Multiply Mrs. Gherkin‟s current Social Security benefit of $1,229 by that factor, to determine her current countable “Pickle” income.

$1229 multiplied by .273 = $335 (“Pickled” Social Security income, rounded downward) $335 countable Social Security income + $275 private pension = $610 total countable “Pickle” income.

Since $610 is less than the current SSI income limit (including the standard $20 disregard) of $718,

Mrs.Gherkin is eligible for Medicaid, even though she is ineligible for SSI.