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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

4 REVISED 10/01/05 - CHANGE NO. 28-05 (I.D.3)

a. Treat the non-SSI spouse as a budget unit of one effective the month the SSI individual is authorized for SSI Medicaid. Apply Maintenance Allowance Adjustment.

b. Follow MA-2340, Change In Situation, or Family and Children’s Manual, MA-3410, Terminations and Deletions, for instructions to delete budget unit members.

4. If the SSI recipient is in deductible status in a multiple person MAF case the message is: IND DEL-EIS has created an SSI Medicaid case.

a. Recalculate the six month deductible based on the number of months the SSI individual was in the certification period.

b. Delete the SSI individual from the budget unit effective the month of SSI Medicaid authorization.

c. Notify the ongoing MAF case of the amount of the new deductible.

E. SSI Approval with MQB Case in EIS

1. Each individual in an authorized MQB case in EIS who begins to receive SSI is identified to the county dss on the DHREJ SSI MED CREATED/MODIFIED Report. The message is: CAS TRM-EIS has created an SSI Medicaid case. This report is generated in XPTR each time an MQB case in EIS is terminated and a MAABD case is created as a result of an SSI approval. Refer to EIS 4200 for additional information on the report.

2. If the MQB recipient was on a deductible, follow instructions in D. above, to recalculate the six month deductible for the SSI individual for the period prior to the SSI Medicaid authorization.

F. SSI Approval with Existing HSF Case

1. When an authorized HSF recipient is approved for SSI, the SSI status is set to "Y". The case remains in HSF. This situation is not identified on the DHREJ SSI MED CREATED/MODIFIED Report.

2. If the HSF case is in deductible status, the SSI status is set to "Y" and the case is automatically authorized effective the month of SSI approval. Individuals in HSF who go from deductible status to authorized are identified on the DHREJ SSI MED CREATED/MODIFIED Report. The message is: SSI MED-Non-SSI EIS cases that change to SSI Medicaid. Follow instructions in D., above to recompute the deductible for the time prior to SSI Medicaid authorization, if applicable.

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Official source

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

4 REVISED 10/01/05 - CHANGE NO. 28-05 (I.D.3)

a. Treat the non-SSI spouse as a budget unit of one effective the month the SSI individual is authorized for SSI Medicaid. Apply Maintenance Allowance Adjustment.

b. Follow MA-2340, Change In Situation, or Family and Children’s Manual, MA-3410, Terminations and Deletions, for instructions to delete budget unit members.

4. If the SSI recipient is in deductible status in a multiple person MAF case the message is: IND DEL-EIS has created an SSI Medicaid case.

a. Recalculate the six month deductible based on the number of months the SSI individual was in the certification period.

b. Delete the SSI individual from the budget unit effective the month of SSI Medicaid authorization.

c. Notify the ongoing MAF case of the amount of the new deductible.

E. SSI Approval with MQB Case in EIS

2. If the MQB recipient was on a deductible, follow instructions in D. above, to recalculate the six month deductible for the SSI individual for the period prior to the SSI Medicaid authorization.

F. SSI Approval with Existing HSF Case

1. When an authorized HSF recipient is approved for SSI, the SSI status is set to "Y". The case remains in HSF. This situation is not identified on the DHREJ SSI MED CREATED/MODIFIED Report.