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UPDATED: FEBRUARY 2005

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INCOME

SSI-RELATED BUDGETING METHODOLOGY

Description: New York State has contracted with the Social Security Administration so that eligibility for SSI generally means automatic eligibility for Medicaid. The SSI recipient does not need to file an application for Medicaid.

There is a group of people, however, who do not receive SSI but who meet the categorical requirements of the program. These persons are: aged (65 or over), certified blind, or certified disabled. Generally, these individuals must apply for Medicaid separately and have their eligibility determined by the local social services district where they live. In determining eligibility for these SSI-related persons, the SSI-related budgeting methodology is used. This methodology is patterned after the method used by the Social Security Administration to determine eligibility for SSI.

Policy: SSI-related budgeting is used to determine eligibility for those persons who are aged (65 or over), certified blind or certified disabled and not in receipt of Supplemental Security Income (SSI). (See CATEGORICAL FACTORS SSI-RELATED)

SSI-related budgeting is used for Medicaid A/Rs for whom payment or part payment of the Medicare premiums, coinsurance and deductibles is made. (See INCOME MEDICARE SAVINGS PROGRAM)

When determining eligibility for the Medicaid Buy-In Program for Working People with Disabilities, SSI-related budgeting, including allocation and deeming is used.

Persons potentially eligible for COBRA continuation of their health insurance when employment ends and those applying for the AIDS Health Insurance Program have their income and resources budgeted in accordance with the SSI-related methodologies.

Disregards of income for SSI-related persons are discussed and listed in INCOME SSI-RELATED DISREGARDS and the determination of eligibility for SSI-related persons is described in INCOME DETERMINATION OF ELIGIBILITY.

References: SSL Sect.

366

Dept. Reg.

360-3.3(a)(3) 360-3.3(b)(1) and (2) 360-4.2

(MRG)