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218 (07/2026) Chapter 2:Eligibility • Section 5: Financial eligibility Note: The SDS 538A should be completed and sent to the Social Security Administration in the following instances: • When assets are identified or reported that would result in ineligibility for OSIPM if the individual were not assumed eligible, or • When an SSI recipient enters a nursing facility. OSIPM HSD A child born to an individual eligible for and receiving any Medicaid or CHIP benefit is assumed eligible for the MAGI Child program until the end of the month the child turns 1 year of age. Protected eligibility OSIPM Disabled Adult Children (DAC) Individuals are evaluated for OSIPM as a disabled adult child if they meet all of the following requirements: • The individual is age 18 or older. • The Social Security Administration has determined that the individual became blind or a person with a disability before reaching the age of 22. • The individual lost SSI benefits on or after July 1, 1987, because either the individual became eligible for Social Security DAC benefits when a parent died, retired or became disabled and began receiving Social Security Benefits (SSB); or the individual was already receiving SSB and SSI at the same time but lost SSI because the SSB increased. (An individual who receives railroad retirement benefits (RRB) does not meet this requirement--it must be SSB). • The individual would continue to be eligible for SSI in the absence of the Social Security DAC benefits or increases to that benefit. Note: A DAC is exempt from a service liability if receiving waivered services; however, DAC individuals must pay a service liability if receiving nursing facility services. Pickle Amendment individuals An individual is eligible for OSIPM under the Pickle Amendment if they meet all other eligibility requirements, but is over income because of Social Security Title II Benefits (SSB/SSDI) cost-of-living increases after April 1977, and: • Is receiving SSB or SSDI Title II benefits for the aged, survivors or persons with disabilities, (An individual who receives railroad retirement benefits (RRB) does not meet this requirement--it must be SSB/SSDI). • Was eligible for and receiving SSI or state supplements but became ineligible for those payments after April 1977 (individual does not have to lose SSI due to COLA), and • Would be eligible for SSI or state supplement if the SSB/SSDI COLA increases paid under section 215(i) of the Social Security Act were deducted from current SSB/SSDI benefits; this applies after the last month the individual was both eligible for and received SSI or a supplement and was entitled to SSB/SSDI.