Previous Policy

Introduction

Medicaid is available to individuals who are aged, blind or disabled.

· Aged Medicaid is available for people who are 65 or older.

· Blind Medicaid is for people who meet the Social Security criteria for being blind. They may not necessarily have other disabilities.

· Disabled Medicaid is for people who meet the Social Security disability criteria.

The Social Security Administration (SSA) defines the criteria used to decide someone is blind or disabled. People approved as blind or disabled by SSA do not need a disability decision from the State Medicaid Disability Office (SMDO). If an applicant does not have a decision from SSA, the SMDO can review medical evidence to decide if the person is disabled.

A. Basic Eligibility Criteria

1. Individuals who are 65 or older may qualify for Aged Medicaid. Eligibility for Aged Medicaid can begin the month the individual turns 65.

2. Individuals who have a birth date on the first of the month, are eligible for Medicare beginning the first of the previous month but are not eligible for Aged Medicaid in that month.

3. People determined blind or disabled by either the SSA or the SMDO may receive Blind or Disabled Medicaid. Eligibility may begin in the first month for which the blindness or disability is effective, but no earlier than the 3rd month before the month of application.

4. Aged, blind or disabled individuals may qualify for other Medicaid programs, as well.

5. Individuals under 65 who claim to be blind or disabled, but have not been determined disabled by SSA, may receive a decision from the SMDO.

People must meet an asset test ( 503 ) as well as an income test ( 443-1 ), in addition to the non-financial criteria all Medicaid applicants and recipients must meet. Income criteria may include deeming income from an ineligible spouse ( 410-2 ), or for a child, deeming income from an ineligible parent. ( 410-3 )

B. Requesting a SMDO Decision

The following sections provide the requirements for requesting a decision from the SMDO about a person's blindness or disability.

303-2 Proof of blindness or disability

303-3 When to establish blindness or disability from the State Medicaid Disability Office

303-4 Effective date of disability

303-6 When SSI or SSDI Benefits End

303-7 Appeals of the SSA decision

303-8 Blind or Disabled Medicaid eligibility for past months

303-10 Persons being released from the State Hospital or a public institution