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North Carolina Department of Health and Human Services AGED, BLIND AND DISABLED MEDICAID MANUAL
MA-1100 AGED, BLIND AND DISABLED
SSI MEDICAID – COUNTY DSS RESPONSIBILITY
12 REISSUED 11/01/11 – CHANGE NO. 17-11 (IV.D.) 5. Determine PML per MA-2270, Long Term Care Need and Budgeting.
a. The PML is “0” for the month of entry.
b. Do not count the SSI payment when determining the PML.
E. Individual Ineligible for Cost of Care
If the individual is ineligible for payment of cost of care due to inappropriate level of care, transfer of assets sanction, or excess reserve, send a DSS-8109/DSS-8109S, Notice of Benefits Denied or Withdrawn, to deny payment for cost of care.
F. Individual Eligible for Cost of Care
When it is established the recipient is eligible for payment of cost of care, take the following steps:
1. Update the following fields in EIS: a. County Number b. District # and Worker # c. Address d. Maintenance Allowance e. Earned Income, Unearned income, Total Countable Income f. PML g. Medicaid Effective Date h. Living Arrangement Code
2. Complete and send the DMA-5016, Notification of Eligibility for Medicaid/Amount and Effective Date of Patient's Liability, to the facility. Ensure the PML reported to the facility agrees with the PML in EIS.
3. Send a DSS-8110/DSS-8110S, Notice of Change in Benefits, to notify the recipient he is eligible for payment of cost of care. Also use the DSS-8110/DSS- 8110S, Notice of Change in Benefits, to:
a. Advise him that if his SSI terminates, his cost of care will also terminate.
b. Instruct him to notify the dss of any change in living arrangement or if his SSI terminates.