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Aged, Blind and Disabled Manual; Section: Categories of Eligibility; Policy Manual Number: 115.025; Chapter: SSI CASH RECIPIENT

Legal Authority: 20 CFR 416.260; 20 CFR 416.903; 20 CFR 416.974; 42 CFR 435.120; Title XVI of the Social Security Act; Tenn. Comp. R. & Regs. 1200-13-20-.08

1. The SSI Program and Medicaid Eligibility The Social Security Act, as amended, established a national program, effective January 1, 1974, to provide Supplemental Security Income (SSI) to individuals who have attained age 65 or are blind or disabled and meet financial requirements. The program is intended to assure a minimum level of income for individuals who are aged, blind, or disabled that have insufficient income and resources to maintain a standard of living at the established federal minimum income level.

Individuals who are eligible for SSI are entitled to Medicaid. SSI eligibility is determined by the Social Security Administration (SSA) in Tennessee. Applications for SSI benefits may be filed at the Social Security office.

TennCare does not conduct an independent evaluation of income and resource eligibility before issuing regular TennCare Medicaid benefits to an SSI recipient.

2. Policy Statement TennCare Medicaid is provided to aged, blind or disabled individuals eligible for SSI under Section 1602 of the Social Security Act. Tennessee residents determined eligible for SSI benefits are automatically enrolled in TennCare Medicaid.

SSI recipients who are enrolled in TennCare Medicaid also receive automatic buy-in for Medicare Parts A & B.

3. Date of TennCare Medicaid and SSI Eligibility TennCare Medicaid coverage for SSI cash recipients begins according to data TennCare receives from the SSA regarding SSI eligibility.

4. SSI Benefit and TennCare Medicaid Termination SSA alerts TennCare when an SSI recipient’s SSI payments end. At that time, TennCare will review the enrollee for eligibility in all other categories prior to termination.