Page 8

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

8 REISSUED 10/01/05 – CHANGE NO. 28-05 (II.E) 2. If it is an MAD application and disability has not been established for the retroactive period, follow instructions in MA-2525, Disability. This is an MAD-Y application. Send the required information to Disability Determination Services (DDS).

3. If eligible under any Medicaid coverage group in the retro period, approve the application as open/shut. Refer to EIS 4200 for instructions to authorize when eligibility is established under a Family and Children's coverage group.

4. Follow procedures in MA-2395, Corrective Actions and Responsibility For Errors, to request an override when the 365 day limit for filing claims has expired or less than 60 days remain before the time limit expires.

5. If the individual is not eligible in any Medicaid coverage group in the retro period, deny the application per MA-2304, Processing the Application.

III. COUNTY DSS RESPONSIBILITY FOR SSI APPLICANTS WHO DIE PRIOR TO DISPOSITION

This section only applies to deceased individuals who applied for SSI prior to their death.

A. Policy Rules

1. The county dss can protect the SSI date of application for retroactive Medicaid and ongoing Medicaid when an SSI applicant dies before SSA establishes eligibility for SSI.

2. The representative must request Medicaid within 60 days (90 days with good cause) from the date of the SSI disposition notice.

B. Establish Timely Application

Follow instructions in II.B. to establish the application is timely.

C. Establish the Retroactive and Ongoing Period

1. The retroactive period is 1, 2, or 3 month period prior to the SSI month of application. Verify this date on screen two of the on-line SDX.

2. The ongoing period begins with the month of SSI application and continues through the month of death.

D. Register a DSS-8124

1. Enter the exact first and last name, social security number, and birth date as listed on the SDX or SSA record. This is a new application, not a reapplication.

Page 8

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

5. If the individual is not eligible in any Medicaid coverage group in the retro period, deny the application per MA-2304, Processing the Application.

III. COUNTY DSS RESPONSIBILITY FOR SSI APPLICANTS WHO DIE PRIOR TO DISPOSITION

This section only applies to deceased individuals who applied for SSI prior to their death.

A. Policy Rules

1. The county dss can protect the SSI date of application for retroactive Medicaid and ongoing Medicaid when an SSI applicant dies before SSA establishes eligibility for SSI.

2. The representative must request Medicaid within 60 days (90 days with good cause) from the date of the SSI disposition notice.

B. Establish Timely Application

Follow instructions in II.B. to establish the application is timely.

C. Establish the Retroactive and Ongoing Period

1. The retroactive period is 1, 2, or 3 month period prior to the SSI month of application. Verify this date on screen two of the on-line SDX.

2. The ongoing period begins with the month of SSI application and continues through the month of death.

D. Register a DSS-8124

1. Enter the exact first and last name, social security number, and birth date as listed on the SDX or SSA record. This is a new application, not a reapplication.