Policy Frameworks for Designing Medicaid Buy-In Programs and Related State Work Incentive Initiatives. Policy Frameworks for Designing Medicaid Buy-In Programs and Related State Work Incentive Initiatives : Table 9

05/01/2002

: Table 9

STATE OPTIONIMPACT ON ACCESS TO WORK INCENTIVES
Section 1634 Option -- A state enters into an agreement with SSA under which SSA determines eligibility for MedicaidSSI recipients do not have to make a separate application for Medicaid. Automatic continuation of Medicaid under Section 1619(b) when earnings take them out of SSI cash payment status. Persons who are only eligible for SSI because of the state SSI supplement, and SSA administers supplement, are provided the protections under Section 1619 for continued SSI and Medicaid if their earnings take them over the SGA earnings test level or income means test level.
State Uses SSI criteria for eligibility for Medicaid for SSI recipients but separate application for Medicaid required by SSI recipientState must ensure that individuals who lose their SSI payment status because of earnings are informed that they remain eligible for Medicaid under Section 1619(b). State must utilize SSA data to track status of individual and ensure continued Medicaid eligibility. If state administers state SSI supplement, including those without federal SSI benefits, individual should remain eligible for Medicaid under Section 1619(b) if earnings takes them above state SSI supplement standard.
State 209(b) Option -- State uses Medicaid eligibility criteria that are different than the SSI standards but not more restrictive than the state’s approved Medicaid state plan in January 1972 -- the year the SSI law was enactedSSI recipients are required to make a separate application to the state for Medicaid to become eligible. Section 209(b) states must provide continued Medicaid eligibility under Section 1619(b) when an SSI recipient loses SSI benefit payment status because their earnings takes them above the SSI benefit standard if in the previous month they were eligible for Medicaid under the state’s Medicaid program. State must ensure that individuals who lose their SSI payment status because of earnings are informed that they remain eligible for Medicaid under Section 1619(b). State must utilize SSA data to track status of individual and ensure continued Medicaid eligibility.