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MISSISSIPPI DIVISION OF MEDICAID Eligibility Policy and Procedures Manual CHAPTER 101 – Coverage Groups and Processing Applications and Reviews Page |105 Effective Month: December 2016 101.02.02 MANDATORY CATEGORICALLY NEEDY - ABD The following are ABD coverage groups that must be covered, as required by federal law: Mandatory Coverage of SSI Recipients Coverage is mandatory for individuals receiving Supplemental Security Income (SSI) in Mississippi. This includes individuals receiving SSI pending a final determination of blindness or disability, those receiving SSI under an agreement to dispose of resources that exceed the SSI resource limit, and those receiving benefits under section 1619(a) or considered to be receiving SSI under 1619(b) of the Social Security Act. Coverage also includes those who would be eligible for SSI except for an eligibility requirement used in the SSI program that is specifically prohibited under title XIX. Eligibility for SSI is determined by the Social Security Administration. No separate application for Medicaid is required unless the individual needs to apply for retroactive Medicaid for up to three (3) months prior to the month of the SSI application, in which case the individual must apply with the Division of Medicaid for the retroactive period of eligibility. Mandatory Coverage of Certain Former SSI Recipients Certain former SSI recipients qualify for Medicaid to continue once their SSI terminates if the use of specific income disregards allows Medicaid eligibility. Medicaid eligibility is based on SSI income and resource limits. The Division of Medicaid certifies eligibility for all of the former SSI groups, as follows: • Cost of Living Individuals – these are former SSI recipients who become ineligible for SSI cash assistance as a result of a cost-of-living increase in title II benefits received after April, 1977. These individuals must be granted Medicaid coverage if the sole reason for the loss of SSI was an increase in RSDI benefits received by the individual and/or his or her financially responsible spouse. • Disabled Adult Children – these are former SSI recipients age 18 or over whose disability onset date was prior to turning age 22. SSI must have been paid at any time after July, 1987 and closed when title II benefits from a parent’s record began or increased, whichever caused the SSI to terminate. • Coverage is mandatory for certain disabled widows and widowers who would be eligible for SSI except for receipt of Social Security widow(er) benefits that terminated SSI. The individual must be age 50 through 64 and not eligible for Medicare in order to be evaluated for coverage under this provision.