Eligibility Online Manual
M1005A Disabled Adult Child (DAC)
Purpose: This section will assist in determining whether an individual is eligible for Medicaid benefits as a Disabled Adult Child (DAC).
Current Policy Effective Date: December 1, 2018
Date Last Reviewed: October 24, 2018
Previous Policy: September 1, 2010
POL M1005A: DETERMINING ELIGIBILITY FOR DISABLED ADULT CHILD (DAC)
1. Applicants Must Meet Basic Eligibility Factors
Refer to Section M600 for a description of all basic eligibility factors.
2. Social Security Administration (SSA) Determines Eligibility
The State Data Exchange (SDX) shows eligibility with a Medicaid eligibility code of “D.” Applicant is eligible for the Disabled Adult Child (DAC) program without a Medicaid application.
3. Applicants May be Eligible For Disabled Adult Child (DAC)
When the SDX shows a Medicaid test indicator code “R” or applicant is not on the SDX, a Medicaid application is required to determine if the client meets the eligibility for DAC.
Require Applicants to meet the following criteria to be eligible for the DAC Program:
Age 18 or Older
Disability began before age 22
Lost Supplemental Security Income (SSI) due to the entitlement to or an increase in DAC benefits. Verify using one of the following:
Letter from SSA; Or
Collateral Contact with SSA.
4. Meets Income Requirements
Require the countable income, excluding the DAC payment, to be within the maximum Supplement Security Income (SSI) payment standard. Refer to Medicaid Table 1A for income standards. Refer to Section M901 to determine if income is countable.
5. Meets Resource Requirements
6. Clients Must Be Reviewed
Clients must be periodically reviewed every 12 months to determine continued eligibility. Refer to Section M1403 for information on reviewing eligibility.
Clients must be reviewed for other Medicaid program eligibility before closing case.
7. Clients May Lose Benefits
The case will close on the first day of the next month when any of the following occur:
Client does not complete a review
Client enters a public institution, excluding the Geriatric Hall at the State Hospital in Evanston.
Client determined no longer eligible.
Defining Group: 42 CFR 435.120