400.04.03 WIDOW(ER)S WITHOUT MEDICARE ELIGIBILITY CRITERIA (COE’S

095/096) The Widow(er) groups are referred to as OBRA Widow(er)s because both groups stemmed from Omnibus Budget Reconciliation Acts, as follows: • The Omnibus Reconciliation Act of 1987 (P.L. 100-203) mandated Medicaid coverage for certain widow(er)s age 60 to age 65 effective July 1, 1988, and after. These are referred to as OBRA-87 Widow(er)s and are placed in COE- 095. • The Omnibus Reconciliation Act of 1990 (P.L. 101-508) mandated Medicaid coverage for certain widow(er)s age 50 – 59 effective January 1, 1991. These are referred to as OBRA-90 Widow(er)s and are placed in COE-096. The eligibility criteria for both groups are as follows: • The widow(er) must continue to be eligible for SSI on all factors but for their title II benefits. • The widow(er) must have received an SSI payment the month before title II payments began; and, • The widow(er) must not be entitled to Medicare. NOTE: Medicare eligibility can begin prior to age 65 under certain conditions. If Medicare entitlement starts for a widow(er) prior to age 65, Medicaid cannot be determined or continued as an OBRA Widow(er), in either group, as of the month Medicare Part A and/or B begins. • OBRA Widow(er)s receive a disregard of their title II widow(er) benefits and any other paid title II benefits that resulted in the termination of their SSI benefits. • All OBRA Widow(er) applications must be referred to the Central Office for review and determination of the OBRA disregard amount prior to approval.