Medicaid Policy
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Aged, Blind, Disabled, and Long Term Care
A. Retroactive benefits are payments issued more than a month after the calendar month for which they are being paid. For example, the SS DI benefit for January issued in February is not a retroactive benefit. If the January benefit were issued in March, it would be a retroactive benefit.
1. Retroactive Social Security and Railroad Retirement Benefits Received On Or After March 2, 2004.
Exclude lump sum retroactive benefits received on or after March 2, 2004 from the Social Security Administration (SSA and SSI) and from the Railroad Retirement Board for 9 months after the month of receipt. Some lump sums must be paid in installments six months apart. Apply the 9-month exclusion to each payment beginning with the month after such payment is received.
2. Retroactive Social Security and Railroad Retirement Benefits Received Before March 2, 2004.
Exclude lump sum retroactive benefits received before March 2, 2004 from the Social Security Administration (SSA and SSI) and from the Railroad Retirement Board for 6 months after the month of receipt.
3. (See Sections 521-30 and 531-2 for lump sums of retroactive benefits paid to children that must be deposited into a “dedicated account.” See 417-16 for excluding interest.)
B. Reissued Benefits Misused by a Representative Payee.
Social Security benefits (SSI or SSA) or Railroad Retirement benefits for prior months may be reissued to the individual, or spouse, when Social Security has determined that a representative payee misused the funds. Exclude such reissued benefits from countable resources for nine months after the month of receipt. The same nine-month exclusion applies when such benefits are reissued to an individual from whom we deem income such as the parent of an eligible child.
Medically Needy Family, Child and Pregnant Woman)
Exempt lump sum retroactive benefits received on or after July 1, 2005 from the Social Security Administration (SSA and SSI) and from the Railroad Retirement Board for 9 months after the month of receipt. Exclude lump sums received before July 1, 2005 for six months after the month of receipt.
Some lump sums are required to be paid in installments, 6 months apart. Apply the nine-month exclusion (or six months if applicable) to each payment beginning the month after each payment is received. Always assume that the individual spends the amounts received first before amounts received later when deciding what portion of the account balance to exclude. See Sections 521-30 and 531-2 for lump sums paid to children that must be deposited into a dedicated account.