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The SA level of care the person was in when they lost their SA will determine the maintenance amount for Medicaid Pass-along (SA Basic or Special Care Unit (SCU))

2. If the countable income is above the current SSI or SA income limit, the individual is not eligible for COLA Pass-along.

a. DO NOT disregard COLA. This person is ineligible under COLA Pass-along. b. If ineligible for COLA Pass-along, 1. Count the a/b and financially responsible person’s current RSDI income

2. Document in NC Fast and

3. Send the appropriate notice(s).

EXAMPLE : (COLA Pass-along) Applicant/Beneficiary (a/b), age 55, lives alone in their own home with countable assets less than $2,000. The a/b receives countable RSDI benefits in the amount of $1480 ($1,500 minus $20 disregard) a month which is over the Categorically Needy income limit for Medicaid.

A/B was informed by local agency that they have a large Medicaid deductible they must meet prior to Medicaid authorization.

A/B applied for RSDI and SSI in October 1985, alleging disability beginning October 1984 and was approved for disability in October 1986, as of the alleged onset date. A/B was initially paid SSI for October 1985 through December 1986 under SSA normal procedures (in order to provide Medicaid eligibility).

A/B received their first RSDI check in December 1986, which caused SSI to terminate at the end of December 1986. They also received retroactive RSDI benefits during the same time period which were reduced by the amount of SSI received. The regular RSDI monthly payment exceeded the income limit for SSI.

Disregard RSDI COLA increases since the 1986 SSI termination.

$ 1500 (a/b’s RSDI) x 0.338 (use the year 1986 percentage from Pickle Chart below) $507 (round up) - $20 (disregard) $487 (under the 2026 SSI income limit)

The a/b is Medicaid eligible based on COLA Pass-along (but not SSI eligible).

EXAMPLE: (COLA Pass-along couple) An applicant lives at home with their 75- year-old spouse who receives RSDI retirement of $1100/month. The spouse has never received SSI.

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Official source

The SA level of care the person was in when they lost their SA will determine the maintenance amount for Medicaid Pass-along (SA Basic or Special Care Unit (SCU))

2. If the countable income is above the current SSI or SA income limit, the individual is not eligible for COLA Pass-along.

a. DO NOT disregard COLA. This person is ineligible under COLA Pass-along. b. If ineligible for COLA Pass-along, 1. Count the a/b and financially responsible person’s current RSDI income

2. Document in NC Fast and

3. Send the appropriate notice(s).

A/B was informed by local agency that they have a large Medicaid deductible they must meet prior to Medicaid authorization.

Disregard RSDI COLA increases since the 1986 SSI termination.

$ 1500 (a/b’s RSDI) x 0.338 (use the year 1986 percentage from Pickle Chart below) $507 (round up) - $20 (disregard) $487 (under the 2026 SSI income limit)

The a/b is Medicaid eligible based on COLA Pass-along (but not SSI eligible).

EXAMPLE: (COLA Pass-along couple) An applicant lives at home with their 75- year-old spouse who receives RSDI retirement of $1100/month. The spouse has never received SSI.