101.05.01 APPLICATIONS FOR SSI APPLICANTS

SSI applicants who file an application with SSA will automatically receive Medicaid for months SSI is approved. A systems-generated notice of Medicaid approval is issued by DOM providing the beginning date of SSI/Medicaid eligibility and informing the SSI recipient that retroactive Medicaid is available. The notice provides the name, address and phone number of the Medicaid Regional Office where a retroactive Medicaid application may be filed. This notice is separate from the SSI notice of approval. SSI applicants who are denied SSI receive a systems-generated notice of Medicaid denial issued by DOM explaining that although SSI/Medicaid is denied, eligibility for Medicaid-only is available. The various ABD coverage groups are described in the notice and so is the availability of retroactive Medicaid. The notice provides the name, address and phone number of the Medicaid Regional Office where a retroactive Medicaid and/or Medicaid-only application may be filed. This notice is separate from the SSI notice of denial. An SSI applicant may apply for SSI and for Medicaid-only with DOM on the same date or for the same time period. When an application is filed for both SSI and for Medicaid-only, a decision is required by DOM on the Medicaid application. It is not appropriate to hold the application while waiting on the SSI decision nor is it appropriate to deny the application because the applicant has an application pending with SSA. If retroactive Medicaid is requested, a Medicaid decision on the retroactive month(s) is required regardless of whether the SSI application is approved or denied. Follow policy outlined in 101.10.06 for SSI Eligibles requesting retroactive Medicaid and/or eligibility for missing month(s) of SSI eligibility. Follow policy outlined in 500.10.01 for SSI Eligibles entering Long Term Care who need the LTC per diem payment authorized by DOM.