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North Carolina Department of Health and Human Services North Carolina Medicaid Division of Health Benefits AGED, BLIND AND DISABLED MEDICAID MANUAL MA-2110

PASS-ALONG ____ REVISED 01/5/2026 – CHANGE NO. 01-26 I. INTRODUCTION TO PASS-ALONG To preserve Medicaid coverage for certain groups of individuals who lose Supplemental Security Income (SSI) and/or Special Assistance (SA), Congress enacted special Medicaid eligibility provisions. These provisions require the State to continue to evaluate specified groups of former SSI and SA beneficiaries under categorically needy criteria. Qualified individuals are eligible for a disregard of certain Retirement, Survivors, and Disability Insurance (RSDI) benefits. This is called Pass-along. Pass-along only applies to Private Living Arrangement (PLA) budgeting and to Step I of Long-Term Care (LTC) budgeting.

A. Four Eligibility Groups for Pass-along

1. There are four eligibility groups for Pass-along:

a. Cost of Living Allowance (COLA)/Pickle Amendment Group

b. Disabled Adult Children (DAC)

c. Early Widow(er)

d. Disabled Widow(er)

2. A former State/County Special Assistance beneficiary may also qualify for Pass-along in any of these four groups as long as the individual continues to reside in an Adult Care Home (ACH), even if they never received SSI.

B. Pass-along Eligibility

1. An applicant/beneficiary (a/b) need not claim Pass-along status. Many may not be able to remember when or if they received SSI or SA.

2. Fully investigate Pass-along eligibility in every case where the a/b is otherwise over income for Categorically Needy Medicaid Aged, Blind, Disabled (CN MAABD) because of income from Social Security.

3. Once an a/b is determined to be Pass-along eligible in one of the four groups, always consider the a/b as Pass-along in subsequent recertifications and applications unless one of the eligibility requirements for that Pass-along group changes.

C. Evaluating for Pass-along When determining Pass-along eligibility, NC FAST will systematically screen for eligibility in all applicable Pass-along groups.