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Issue Alert - 08-03-01
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| Date: | Mar 15, 2008 | |
| Program Area: |
Medicaid (MA) |
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| Issue Summary: |
Individuals seeking Medicaid will have longer to spend their retroactive Supplemental Security Income (SSI) and Social Security (RSDI) benefits under new policy excluding the retroactive awards as being counted as assets for 9 months after they are received, when determining eligibility for “SSI-related Medicaid” (Medicaid for persons who are disabled, blind or elderly (65+) ) |
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| Persons Affected: |
Medicaid applicants or recipients who have received an award of retroactive SSI or RSDI benefits |
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| For More Information: |
Center for Civil Justice 320 S. Washington, 2nd Floor Saginaw, MI 48607 (989) 755-3120, (800)724-7441 Fax: (989) 755-3558 E-mail: info@ccj-mi.org
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| Background | ||
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Medicaid has dozens of
eligibility “categories”. Categories
that provide coverage to individuals because they are aged (age 65 or older),
blind, or disabled are known as “SSI-related” categories. See DHS Program Eligibility Manual (PEM) Item 105. (DHS manuals and policies are available online at http://www.mfia.state.mi.us/olmweb/ex/html/.) As the
name suggests, eligibility for SSI related Medicaid categories must be
determined using the same “methodology” as the SSI program. Therefore, assets or income that is not
counted when determining SSI eligibility also must be excluded when determining
eligibility for SSI-related Medicaid categories. See 42 USC 1396a(a)(10)(C)(i)(III)
and 1396a(r)(2); 42 CFR 435.601(d). |
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| What's Happening? | ||
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As the result of advocacy by Deb
Hemgesberg at the Association for Community Advocacy, the Medicaid agency has
agreed that the policy in PEM 400 is incorrect and retroactive SSI and Social
Security awards must be excluded as assets for 9 months, rather than 6
months. |
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| What Should Advocates Do? | ||
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Watch
for clients who may be threatened with termination or denial of Medicaid based
on retroactive SSI or RSDI benefits that were received more than 6, but less
than 9, months previously. Ask DHS workers to check for the clarification
that should be posted in PEM 400 if your clients encounter this problem. Remember that clients will be asset
eligibility for SSI-related Medicaid if their assets are below the asset limit
for at least one day in the month for which they are seeking eligibility. 2. When
you successfully represent clients in SSI and RSDI cases, give accurate advice
on the length of time (9 months) that they have to spend the retroactive
benefits before they will be counted as assets that may affect Medicaid
eligibility. Advise clients that it is best to keep
retroactive benefits in a separate account (don’t commingle with other funds)
so that it will be clear which funds are not countable. Advise clients that they should get legal
advice immediately if they are threatened with termination or denial of
Medicaid based on retroactive SSI or RSDI benefits that were received more than
6, but less than 9, months previously. 3.
Share this information with other practitioners who handle SSI or RSDI
cases. |
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| What Should Clients Do? | ||
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1. Keep track of the 9
month deadline after which your retroactive award of SSI or RSDI will counted
toward your Medicaid asset limit. 2. Keep your retroactive
award in a separate bank account, if possible. 3. Do not ignore notices
about Medicaid terminations – you must request a hearing before the scheduled
date of the termination to keep your Medicaid while your hearing request is
pending. DHS must receive your original,
signed hearing request before that scheduled termination date. |
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| Finding Help | ||
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Most legal aid and legal services offices handle these types of cases, and they do not charge a fee.
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