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MAABD MAABD MAABD MAABD MAABD MAABD MAABD MAABD MAABD MAABD MAABD B-320.4 Division of Welfare and Supportive Services Medical Assistance Manual 25 Mar MTL 02/25 MAABD MEDICAL CATEGORIES WIDOWS, WIDOWERS AND SURVIVING DIVORCED SPOUCES a. They were receiving SSI for the month prior to the month they began receiving Title II benefits; and b. They would continue to be eligible for SSI if the amount of the Title II benefit was not counted as income; and c. They are NOT entitled to Medicare Part A hospital insurance. Verification: Social Security identifies individuals who are possibly eligible under this category with an "S" in the SDX Public Law column. If an SDX is received identifying an individual as such, it is the responsibility of the case manager to determine if the individual meets the above criteria. Note: Individuals eligible for medical assistance under this provision will lose Medicaid eligibility at the time they reach age 65 or become eligible for Medicare, whichever comes first, unless they are found to be eligible for Medicaid under another category. The case manager shall document the case to show what amount of benefit is being disregarded. If the case manager cannot tell from the SDX what amount should be disregarded, Social Security should be contacted to verify. B-320.5 Suspension of SSI Due to Income – Public Law 96-265 Provides extended medical assistance for certain disabled/blind persons whose SSI is suspended due to excess earned income. Verification: Social Security determines this Public Law status and identifies these cases via the SDX. When the Payment status code is NO1 or PO1 and SSA has determined the case to be one which falls under Public Law 96-265, Alpha Code "I" will appear in the SDX Public Law column. If a subsequent SDX is received and Alpha Code "I" has disappeared, it is the responsibility of the case manager to determine if the individual continues to meet the above criteria. The case manager must document the case and Social Security should be contacted to verify ongoing eligibility status. Disabled individuals who work can continue to receive SSI, and categorical Medicaid, even if their earned income exceeds the Substantial Gainful Activity (SGA) limits. SSA pays no cash benefit in this situation but individuals remain eligible for Medicaid as if they were still receiving an SSI payment. B-320.6 Persons Ineligible for SSI Due to Alien Sponsor Deeming (CFR 416.1160) Aged and disabled individuals who are ineligible for SSI due to alien sponsor deeming are considered SSI eligible, and therefore, Medicaid eligible IF they meet all other eligibility requirements. Verification: Obtain verification of SSI ineligibility due to sponsor deeming.