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COMAR 10.09.24.03

353 State of Maryland Medical Assistance Manual Revised July 2012 (l) Disabled Adult Children (DAC) If the Social Security Administration (SSA) considers an individual eligible for Supplemental Security Income (SSI), the individual is eligible for MA as an SSI recipient, even if the individual does not receive SSI cash benefits due to receipt or increase of Social Security benefits. An SSI-eligible person who is at least 18 years old is MA-eligible as a Disabled Adult Child (DAC) if the parent, on whom the individual is dependent, dies or receives Social Security benefits as an elderly or disabled person, and the SSI recipient files a claim for Social Security benefits based on the parent‟s Social Security account. If the individual‟s Social Security cash benefit exceeds the SSI benefit, the individual no longer receives SSI cash payments. The individual must be “deemed” by SSA as SSI-eligible in a no-pay status. This sequence of events makes the individual a DAC. Since the individual is still SSI eligible, he/she remains MA- eligible as such. The DAC does not need to file a MA application in order to obtain and retain MA coverage. The MA does not need to file a MA application in order to obtain and retain MA coverage. The MA eligibility CM must assure that the DAC‟s MA eligibility remains active without a break after the SSI payments end, and SSI eligibility continues in a no-pay status. For an individual to be MA-eligible as a DAC, the individual must be “deemed” by SSA as SSI- eligible in a no-pay status. This occurs when the individual becomes income over scale for SSI cash benefits due to receipt or increase of Social Security Childhood Disability Benefits under the parent‟s Social Security account. Eligibility criteria must be met for Childhood Disability Benefits: The individual is at least 18 years old, unmarried, not the head of a household, and dependent on a parent because the individual is blind or disabled; The individual has blindness or a disability that began before age 22; and The individual‟s parent either died or became eligible for Social Security because the parent is elderly or disabled. The State Data Exchange System (SDX) or State Verification and Exchange System (SVES) should indicate that the SSI recipient is MA-eligible as a DAC when SSI cash payments end or when SSI eligibility is initiated in a no pay status. SDX/SVES should have the following information in order for an individual to be considered a DAC: DAC Eligibility Criteria The individual is at least 18 years old; The individual has “D”(deemed) as the SSI status for Medicaid eligibility; The individual has “NCI” (no payment) as the SSI payment status; The individual‟s SSA claim number differs from the individuals‟ Social Security number, because he/she eligible under the parent‟s SSA claim number; The individual„s SSA claim number ends with a “C” suffix (Beneficiary Identification Code- BIC), followed by a number (e.g. “212-22-1212 C1).