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:  January 1, 2022

Date Last Reviewed:  

Previous Policy:  December 1, 2018 

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: 

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

Require countable resources to be within the maximum SSI resource standard. Refer to Medicaid Table 7 for resource standards. Refer to Section M801 to determine if resources are countable.

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:

Reference:

Defining Group:    42 CFR 435.120    

Clarifying Information:

Worker Responsibilities: