Eligibility Online Manual
M1005B E01 DETERMINING ELIGIBILITY WITH E01 PAYMENT STATUS
Purpose: This section will assist in determining whether an individual is eligible for Medicaid benefits when the SDX indicates a payment status of E01.
Current Policy Effective Date: September 1, 2010
Date Last Reviewed: March 31, 2010
Previous Policy: January 1, 2007
POL M1005B: DETERMINING ELIGIBILITY WITH E01 PAYMENT STATUS
1. Clients May Have Payment Status Code of “E01”
The SDX shows eligibility with a payment status code of “E01.”
2. Clients Residing in Licensed Medical Institution
The client is SSI eligible, but does not receive a payment because he or she is residing in a licensed medical institution.
3. Clients Potentially Eligible Under Another Medicaid Coverage Group
The client must complete an DHCF-300 Disability Application to determine if eligible under another Medicaid coverage group.
Defining Requirement: Social Security Act § 19
1. E01 is defined as individuals who are SSI eligible but do not receive payments because they are in a licensed medical institution.
2. SSA does not determine Medicaid eligibility for an individual in E01 status on the SDX.
Determining Eligibility Under Another Medicaid Coverage Group
1. Require a DHCF-300 Disability Application.
2. Determine eligibility under another Medicaid coverage group.