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Manual Title Chapter Page Revision Date Virginia Medical Assistance Eligibility M03 September 2012 Subchapter Subject Page ending with Page M0320.000 AGED, BLIND & DISABLED GROUPS M0320.204 12

Individuals who are ineligible because of excess income after the cost-of- living increase(s) is excluded can only become Medicaid-eligible in another covered group. If they do not meet an F&C covered group, are not institutionalized, are not receiving CBC or do not have Medicare Part A, they must be determined eligible in a medically needy covered group. The cost-of-living increase(s) is not excluded when determining income eligibility in ANY other covered group. However, these individuals must be identified for possible future protection as the SSI and AG income limits increase. C. Entitlement & Enrollment Eligible individuals in this group are entitled to full Medicaid coverage beginning the first day of the individual’s application month if all eligibility requirements are met in that month. Retroactive coverage is applicable to this covered group. The ACs are: • 021 for an aged individual; • 041 for a blind individual; • 061 for a disabled individual. D. Eligibility for Non- Protected Family Members The amount of an SSA cost-of-living increase that must be excluded when determining eligibility for a former SSI recipient cannot be excluded when determining Medicaid eligibility of the individual’s non-protected spouse and/or children living with the former SSI recipient. The former SSI recipient is included in his/her non-protected spouse's unit if the non-protected spouse is aged, blind, or disabled. The former SSI recipient is included as a member of the family unit when determining a child’s eligibility in an F&C covered group. All of the protected recipient's income, including the cost-of-living increase(s), is counted.

M0320.204 PROTECTED WIDOWS OR WIDOWERS

A. Policy Two groups of disabled widow(er)s who lost SSI eligibility because of receipt of or increase in Title II disabled widow(er)s’ or Title II widow(er)'s benefits have their Medicaid categorically needy eligibility protected. The first group consists of disabled widow(er)s who would be eligible for SSI except for the increase in disability benefits resulting from elimination of the reduction factor under P.L. 98-21 in January 1984. The second group consists of (1) disabled widow(er)s age 60 through 64 years and (2) disabled widow(er)s age 50 through 59 years who would be eligible for SSI except for early receipt of Social Security benefits. B. July 1989 Protected Widow(er)s 42 CFR 435.137 - A “July 1989 protected widow(er)” is an individual who became entitled to SSA benefits when he/she had attained age 50 but not age 60 years, and