Who is eligible to receive Categorically Needy SSI Related (S02) medical?
How long is the Categorically Needy SSI Related (S02) medical certification period?
When is Categorically Needy SSI Related (S02) medical AUTO opened?
Can a client receive Categorically Needy SSI Related (S02) medical coverage while incarcerated?
Apple Health eligibility manual - WAC 182-503-0505 Washington Apple Health - General eligibility requirements.
Apple Health eligibility manual - WAC 182-512-0100 SSI related medical -- Categorically needy (CN) medical eligibility.
Apple Health eligibility manual - WAC 182-512-0010 Supplemental Security Income (SSI) standards; SSI-related categorically needy income level (CNIL); and countable resource standards.
For more information on how countable income and resources are determined for SSI-related medical assistance, see Apple Health eligibility manual - WACs 182-512-0200 through 182-512-0960 for information on how countable income and resources are determined for SSI-related medical assistance.
S02 Medical is certified for 12 months. For more information, see Apple Health eligibility manual - WAC 182-504-0015 Washington Apple Health - Certification periods for categorically needy (CN) programs.
S02 is AUTO opened in some instances when a Supplemental Security Income (SSI) recipient's payments are stopped by the Social Security Administration (SSA). For more information, see Apple Health eligibility manual - WAC 182-510-0010 What happens to my categorically needy (CN) medical coverage when my supplemental security income (SSI) cash payment is terminated?
When a client active on Medically Need (S95) becomes eligible for CN medical, the medical coverage group on the AU is changed to S02 or Non Citizen CN SSI Related (S07).
How do I screen Categorically Needy SSI Related (S02) medical?
How do I process a pending Categorically Needy SSI Related (S02) Assistance unit (AU)?
On the Finalize page, select the program SSI Related Categorically Need (S02).
Complete the interview following the steps in How do I initiate and complete an intake interview?
Applicant (PN) for the applicant and spouse (if the spouse is applying too).
Child - SSI/Of SSI-related Parent/Used for HH Size (SC) for non applying children of the applicant/s.
ABD Parent (AP) for the parents of the applicant if the applicant is under 18 years old.
On the Client Details page for each applicant(s) enter the disability information in the Disability/Incapacitated/Psychiatric section.
If the S02 program eligibility is based on age, coding the Disability/Incapacitated/Psychiatric section is optional.
On the Unearned Income page, in the Ever Received SSI field check Yes.
Click the Add icon, under Income select Other Agency Application/Benefit and choose the applicant from the Client dropdown menu.
Type field - Select [SSI (SI)] from the drop down menu.
Status field - Select the appropriate SSI termination code.
Date field - Enter [the date the SSI terminated].
Entitled to Medicare - Select [Yes (Y) or No (N)], whichever is appropriate.
For more information, see Apple Health eligibility manual - WAC 182-512-0880 Special Income disregards.
NOTE: Once SSI termination information has been entered in the Ever Received SSI and Application/Benefits fields, these fields are no longer editable. These fields are only editable when ACES receives updated information from SDX and/or BENDEX, AUTO can update the fields as appropriate, or when a user or AUTO enters SSI income back to a case, the information in the fields can be deleted. Only users with SSI SPECIAL AUTH in their ACES profile are permitted update ability for these fields in ACES 3G only.
On the Expense page, click the Add icon to get to the Shelter Expense page for the applicant. Enter [the applicant's shelter expense information] in the appropriate fields.
If no shelter cost is entered, the household's income will be compared to the supplied shelter standard. For more information, see Apple Health eligibility manual - SSI-Related-Income-Countable Income and Program Standards.
On the Resources Vehicles/Vessels page, to exempt the entire value of one vehicle, select Transportation for Disabled Person(TD) in the MA/CA Use field.
Complete all other screens as needed following the instructions in the Interview chapter.
After committing the interview data, follow the instructions in the Process Application Month chapter for all pending months.
After all pending months have been processed, follow the instructions in the Finalize Application chapter to complete the S02 eligibility determination.
If the AU exceeds the income standard for S02 medical, it may trickle to SSI-Related Medically Needy - No Spenddown (S95) or SSI-Related Medically Needy with Spenddown (S99) during finalize.
How do I process a pending S02 (Categorically Needy SSI Related) Assistance Unit (AU)?
From the AMEN, access the pending AU via Option [O] - Interview.
[PN] - Applicant for the applicant and an applying spouse.
[AP] - ABD Parent for the parents of the applicant if the applicant is a child.
[SP] - Ineligible Spouse for an ineligible or non-applying spouse.
[SC] - Child of SSI Related Parents/Child used to determine household size for any non-applying children.
On the DEM2 screen, enter the [applicant’s disability information] in the Disability/Incapacity fields. See <F1> Help.
If the S02 program eligibility is based on age, coding the Disability/Incapacity fields is optional.
Ever received SSI? Field - Enter [Y] - Yes.
Application/Benefit Type field - Enter [SI] - SSI.
Stat field - Enter [the appropriate valid value for the reason the client’s SSI was terminated]. See <F1> help.
Date field - Enter the [date SSI terminated].
For more information about Special Income Disregards, see Apple Health eligibility manual/Income - Special Disregards.
On the SHEL screen, code any shelter costs the client is responsible to pay.
If no shelter cost is entered, the client’s income will be compared to the supplied shelter standard. See WAC 182-512-0010 Supplemental Security Income (SSI) standards.
If the AU exceeds the income standard for S02, it may trickle to SSI-Related Medically Needy - No Spenddown (S95) or SSI-Related Medically Needy with Spenddown (S99) during finalize.