Page 1

Official source

North Carolina Department of Health and Human Services Division of Medical Assistance Medicaid Eligibility Unit AGED, BLIND AND DISABLED MEDICAID MANUAL

MA-1100

AGED, BLIND AND DISABLED

SSI MEDICAID – COUNTY DSS RESPONSIBILITY

1 MA-1100 SSI MEDICAID-COUNTY DSS RESPONSIBILITY REVISED 11/01/11 – CHANGE NO. 17-11

I. COUNTY DSS RESPONSIBILITY FOR SSI APPROVALS

This section provides instructions for situations in which the county dss may have interaction with SSI Medicaid recipients.

A. SSI Approval with Pending Application in EIS

1. Each individual in a pending application in EIS who begins to receive SSI is identified to the county dss on the report: DHREJ SSI IND IN EIS PENDING APP. This report is generated in XPTR at the time of the SDX weekly update. The application remains on the report until it is dispositioned. Refer to EIS 4200 for additional information on the report.

2. When SSI is approved, EIS creates an SSI Medicaid case for the individual and authorizes Medicaid effective the first month SSI is approved.

a. The pending application is not altered in any way.

b. The county dss must approve, deny, or withdraw its application.

c. Continue to follow application processing requirements in MA-2300, Initial Contact, through MA-2304, Processing the Application.

3. Single Person Application

a. Continue to process the application beginning with the month of application (ongoing and retroactive) through the month prior to SSI Medicaid authorization.

b. If the individual has a deductible, recalculate the ongoing deductible based on the income in the months beginning with the month of application through the last month prior to SSI Medicaid authorization.

c. Use the DMA-5097/DMA-5097S, Request For Information, or the DMA- 5099/DMA-5099S, Medicaid Application Pending For A Deductible, to notify the individual of the revised deductible.

d. If the application is approved for the period prior to SSI authorization, approve open/shut.

e. If the individual is ineligible for Medicaid prior to SSI Medicaid authorization, deny the application per MA-2304, Processing the Application.

Page 1

Official source

North Carolina Department of Health and Human Services Division of Medical Assistance Medicaid Eligibility Unit AGED, BLIND AND DISABLED MEDICAID MANUAL

MA-1100

AGED, BLIND AND DISABLED

SSI MEDICAID – COUNTY DSS RESPONSIBILITY

1 MA-1100 SSI MEDICAID-COUNTY DSS RESPONSIBILITY REVISED 11/01/11 – CHANGE NO. 17-11

I. COUNTY DSS RESPONSIBILITY FOR SSI APPROVALS

This section provides instructions for situations in which the county dss may have interaction with SSI Medicaid recipients.

A. SSI Approval with Pending Application in EIS

2. When SSI is approved, EIS creates an SSI Medicaid case for the individual and authorizes Medicaid effective the first month SSI is approved.

a. The pending application is not altered in any way.

b. The county dss must approve, deny, or withdraw its application.

c. Continue to follow application processing requirements in MA-2300, Initial Contact, through MA-2304, Processing the Application.

3. Single Person Application

a. Continue to process the application beginning with the month of application (ongoing and retroactive) through the month prior to SSI Medicaid authorization.

c. Use the DMA-5097/DMA-5097S, Request For Information, or the DMA- 5099/DMA-5099S, Medicaid Application Pending For A Deductible, to notify the individual of the revised deductible.

d. If the application is approved for the period prior to SSI authorization, approve open/shut.

e. If the individual is ineligible for Medicaid prior to SSI Medicaid authorization, deny the application per MA-2304, Processing the Application.