Follow the rules in Section 731 with the following exception:
Use electronic data sources to verify that an individual is receiving SSI. Except for Waiver members (See Long-term Care Medicaid Policy), when an individual receives SSI, it is not necessary to request hard copy verification of their income or to require asset verification unless the information given on their Medicaid application is questionable or incongruent with the receipt of SSI. This is because the Social Security Administration requires an SSI recipient to verify their income and assets at application, at scheduled reviews, and when they report changes. If the individual was not an SSI recipient in some months, for instance in a retroactive period, request hard copy verification of income and determine asset eligibility for those months.
When an SSI recipient is the Medicaid member:
Use electronic data sources to verify the receipt and the amount of SSI benefits. Electronic data sources can also verify the amount of other SS disability, retirement or survivor's benefits. If an electronic match is not found, ask the member for verification of his or her income.
Accept the client’s statement as verification of income and assets for the entire household. Do not require the spouse or parent of an SSI recipient to provide hard copy documents to verify their income.
If a client’s statement of income is incongruent with receipt of SSI use electronic data sources to verify if the income has been reported to Social Security. If not, report the income to Social Security.
If the client’s statement of the value of their assets makes them ineligible, request asset verification. If the verification proves the individual is not eligible, deny the application, and notify Social Security.
When an SSI recipient is part of a household applying for Medicaid for another household member.
Use electronic data sources to verify the receipt and the amount of SSI benefits. Electronic data sources can also verify the amount of other Social Security disability, retirement or survivor's benefits. If an electronic match is not found, ask the individual for verification of his or her income.
Accept the SSI client’s statement as verification for his or her income and assets. If assets are held jointly with another household member who does not receive SSI, request verification when appropriate. (See Section 731)
Request appropriate verification of income for the rest of the household.
When an SSI recipient loses their SSI. (See Section 303-6.)
Remove the SSI income the first possible month.
Verify with electronic data sources or the Social Security office the reason for the loss. If SSI payments will continue within a month or two take no action on verifications.
If the SSI will be discontinued for the foreseeable future, consider eligibility under a protected group, or other medical assistance group.
Based on the reason for the loss of SSI, request needed verifications from the individual and other deemed household members. For example, if SSI benefits stopped because of income, request income verification and determine asset eligibility. Give the individual adequate time to provide verifications (30 days or 90 days, or the business day following the 30th of 90th day as applicable). If necessary, update information by client statement until hard copy verifications can be provided.
If SSI has not been reinstated by the next review, follow the normal verification procedures. See Section 731.