Page 199

West Virginia Income Maintenance Manual Chapter 1

West Virginia Income Maintenance Manual Page 166 Chapter 1 Application/Redetermination Process

1.15 DEEMED SUPPLEMENTAL SECURITY INCOME (SSI) RECIPIENTS Deemed SSI Recipients includes the following: • Disabled Adult Children (DAC) • Blind, Disabled - Substantial Gainful Activity (SGA) • Essential Spouses of SSI Recipients • Pass-Through • Pickle Amendment Coverage (PAC) • Disabled Widows and Widowers • Drug Addicts and Alcoholics 1.15.1 APPLICATION PROCESS No application is required for Deemed SSI Recipients. When SSI benefits are terminated, eligibility as a Deemed SSI Recipient must be evaluated. SDX alerts indicate potential eligibility. • SGAs, Essential Spouses and Pass-Throughs do not require a Worker determination. • PAC AG cases require a financial determination by the Worker and a PAC evaluation is completed for any Medicaid applicant or client who may meet the eligibility requirements. When the Worker determines that the client is a Deemed SSI Recipient, he must enter the appropriate code in the eligibility system. 1.15.2 REDETERMINATION The only Deemed SSI coverage group which requires a redetermination is Pickle Amendment Coverage (PAC). • The PAC redetermination is completed annually. • The redetermination form is generated by the eligibility system and mailed to the recipient in the 11th month of eligibility and is due by the first day of the 12th month. • The redetermination may also be completed using form DFA-PAC-4 or online by using WV PATH.

loading…

Page 199

Official source

West Virginia Income Maintenance Manual Chapter 1

West Virginia Income Maintenance Manual Page 166 Chapter 1 Application/Redetermination Process

1.15 DEEMED SUPPLEMENTAL SECURITY INCOME (SSI) RECIPIENTS Deemed SSI Recipients includes the following: • Disabled Adult Children (DAC) • Blind, Disabled - Substantial Gainful Activity (SGA) • Essential Spouses of SSI Recipients • Pass-Through • Pickle Amendment Coverage (PAC) • Disabled Widows and Widowers • Drug Addicts and Alcoholics 1.15.1 APPLICATION PROCESS No application is required for Deemed SSI Recipients. When SSI benefits are terminated, eligibility as a Deemed SSI Recipient must be evaluated. SDX alerts indicate potential eligibility. • SGAs, Essential Spouses and Pass-Throughs do not require a Worker determination. • PAC AG cases require a financial determination by the Worker and a PAC evaluation is completed for any Medicaid applicant or client who may meet the eligibility requirements. When the Worker determines that the client is a Deemed SSI Recipient, he must enter the appropriate code in the eligibility system. 1.15.2 REDETERMINATION The only Deemed SSI coverage group which requires a redetermination is Pickle Amendment Coverage (PAC). • The PAC redetermination is completed annually. • The redetermination form is generated by the eligibility system and mailed to the recipient in the 11th month of eligibility and is due by the first day of the 12th month. • The redetermination may also be completed using form DFA-PAC-4 or online by using WV PATH.