5101:1-39-02.1 Medicaid: treatment of social security payments made to certain persons who are made ineligible for SSI due to such payments.

(A) Social security child insurance and social security disability income (SSDI) of certain persons who were in receipt of SSI benefits and became ineligible for SSI benefits due to the receipt of SSDI income may, in certain circumstances, be disregarded for purposes of determining medicaid eligibility. This exemption does not apply if the individual is in a long term care facility or enrolled in a home and community-based services waiver.

(B) The following groups of individuals are eligible to have their SSDI income disregarded:

(1) Eligible widows(ers) who meet all of the following criteria:

(a) Entitled to a monthly social security benefit for December, 1983, and

(b) Entitled to, and paid, in January, 1984, a social security widow(er)'s disability benefit, and

(c) On or after January, 1984, were made ineligible for SSI because of an increase in their widow(er)'s benefits which resulted from the social security amendment which eliminated the additional reduction factor for disabled widows or widowers under age sixty, and

(d) They filed a medicaid application or reapplication prior to October 16, 1989, in order to reinstate their medicaid eligibility.

(2) Individuals who have a disability who have attained the age of eighteen and are receiving social security benefits on the basis of blindness or a disability which began before they attained the age of twenty-two, and who meet all of the following criteria:

(a) On or after July 1, 1987, became entitled to social security child's insurance benefits on the basis of such disability or to an increase in the amount of the child's insurance benefits which are payable, and

(b) Were in receipt of SSI benefits prior in the month prior to the receipt of the SSDI benefits; and

(c) Were made ineligible for further SSI benefits solely because of their receipt of such child's insurance benefits or because of the increase in child's insurance benefits.

(3) A widow(er) who was in receipt of SSI and meets all of the following criteria:

(a) Would continue to be eligible for SSI payments but for receipt of SSDI benefits as a disabled widow(er), and

(b) Received an SSI payment the month before the SSDI payments began, and

(c) Is not entitled to medicare part A. The SSDI payment will be disregarded only until the individual becomes entitled to medicare part A.

Eff 4-17-89 (Emer.); 6-30-89; 8-1-90 (Emer.); 10-25-90; 10-24-91 (Emer.); 1-20-92; 7-1-94; 10-1-02
Rule promulgated under: RC 111.15
Rule authorized by: RC 5111.01 , 5111.011
Rule amplifies: RC 5111.01 , 5111.011
Replaces: 5101:1-39-38
R.C. 119.032 review dates: 10/01/2007