Page 12

13

1. Use the following resources to identify individuals who lost SSI or SA eligibility:

a. SDX - The Medicaid Eligibility Code field indicates the eligibility status of “W” for a widow(er).

b. Refer to NC FAST Help job aid, Requesting and Viewing Online Data (OVS) to request SDX information in NC FAST.

c. SDX will not show SSI terminations that occurred prior to 01-01-95. If an SSI termination may have occurred prior to that date, contact SSA. d. SSI Termination/Alert Report and Ex-parte Review for SSI Termination Tasks are available in NC FAST.

(1) It is the responsibility of the county to monitor terminations of SSI benefits and evaluate individuals for all Medicaid programs.

(2) Refer to MA-1000, SSI Medicaid-Automated Process

(3) Refer to NC FAST Help Job Aid, SDX Overview, Tasks, and Work Queues.

e. Verify status by the case record or through the local SSA.

f. Individuals in adult care homes who may have been terminated from Special Assistance.

C. Verify Early Widow(er)’s Pass-along Eligibility Factors. 1. The current amount of the a/b’s RSDI benefit.

2. The a/b’s current ineligibility for Medicare Part A.

D. Early Widow(er)’s Pass-along Eligible If the Individual is determined Early Widow(er)’s Pass-along Eligible, Disregard All the RSDI Income.

E. Determine Countable Income Compare other countable earned and unearned income to the current SSI or SA Income Limit. (Use the 1/3 reduced income limit if appropriate. Refer to MA-2261 1/3 Reduction)

1. If the countable income does not exceed the current SSI or SA income limit, determine eligibility excluding RSDI benefits. This person is eligible under Early Widow(er)’s Pass-along.

2. If the countable income is above the current SSI or SA income limit, the individual is not entitled to Pass-along.