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1139 Chapter 7:Worker guides • Section 7: OSIPM worker guides (07/2026) total countable income is determined, apply the normal deductions to come up with adjusted income. • The individual (or the individual’s financial group) must have resources within the SSI limit. • They must meet residency requirements, disability requirements, etc., so it is possible for an individual to lose their DAC entitlement based on these other requirements. Reasons that a DAC might lose their eligibility include: • The individual may at some point earn enough to start receiving benefits under their own SSN. Usually, a DAC’s own earned income does not affect their DAC status. However, when the individual’s own SSB is higher than the DAC SSB (that is based on the parent’s benefits), the DAC benefits end and the individual is no longer eligible as a DAC. You can verify that the DAC benefits have ended by confirming that current benefits are being paid under the individual’s SSN followed by an “A” code (there is no longer any “C” code for child’s benefits based on the parent’s benefits). Note: Sometimes the individual will begin receiving both benefits under their own SSN and an adjusted amount of DAC benefits. In that case, the individual’s SSN followed by an “A” code will have a CP P-st (pay status) on BEIN, and the DAC SSN followed by a “C” code will have an AD P-st. The AD indicates the payment was adjusted for dual eligibility, and the individual continues to receive DAC payments and be DAC eligible. • The individual may have a medical improvement such that they no longer meet the impairment criteria to qualify for SSI. • The parent on whose case the individual was receiving benefits is no longer disabled. • The individual gets married to someone with too much income • The individual starts receiving other sources of income that put him/her over Cases that have been determined to meet DAC status should be reviewed yearly to determine that the individual continues to meet ALL the eligibility factors for a Medicaid protected DAC. When an individual is determined to meet all the eligibility components as a Medicaid protected DAC, it should be narrated to clearly indicate how the eligibility criteria have been verified. A person who has met the requirements as a Medicaid protected DAC is considered deemed eligible. This means that we protect their Medicaid eligibility from income, but they must meet all other eligibility factors to be considered eligible. An individual who is determined to be a Medicaid protected DAC does not have to contribute towards their cost of services, unless they are receiving nursing facility services. If a person loses their DAC status, they would need to qualify for OSIPM under a different program. An individual who loses SSI for a reason other than those listed above, would not be eligible for protected Medicaid under DAC criteria. Calculating countable income The following is intended to assist in determining how much of the Title II DAC benefits are countable when determining total countable income. If the individual has other income, it would be added to the amount determined below to determine total countable income.