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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 M0320.206 19
D. Entitlement & Enrollment Eligible individuals are entitled to full Medicaid coverage. The ACs are: • 21 for an aged individual; • 41 for a blind individual; or • 61 for a disabled individual. E. Individuals Ineligible as QSII Individuals who are ineligible as QSII because they: • did not receive Medicaid in the month immediately preceding the month in which SSA first determined them eligible under 1619(b) or • lost 1619(b) status must be evaluated for Medicaid eligibility in other covered groups. NOTE: An individual who has 1619(b) status continues to meet the disabled definition. An individual who no longer has 1619(b) status may not meet the disabled definition.
M0320.206 PROTECTED ADULT DISABLED CHILDREN
A. Policy Section 1634(c) of the Social Security Act was amended in 1987 (P.L. 99- 643 §6(b)) to state that if any individual who has attained the age of 18 and is receiving benefits under Title XVI (the Supplemental Security Income program) on the basis of blindness or a disability which began before he or she attained the age of 22 • becomes entitled, on or after the effective date of this subsection (July 1, 1987), to child’s insurance benefits which are payable under section 202(d) on the basis of such disability or to an increase in the amount of the child’s insurance benefits which are so payable; and • ceases to be eligible for SSI because of such child’s insurance benefits under the title or because of the increase in such child’s insurance benefits, shall be treated as receiving SSI benefits for Medicaid eligibility purposes so long as he/she would be eligible for SSI in the absence of such child’s insurance benefits or such increase. B. Nonfinancial Eligibility A protected adult disabled child is one who: • has reached the age of 18 years and receives SSI payments on the basis of blindness or a disability which began before he or she reached the age of 22 years;
• on or after July 1, 1987, becomes entitled to SSA Title II disabled child's insurance benefits on the basis of such disability, or receives an increase in Title II disabled child's insurance benefits;