Eligibility Online Manual

M1005C Goldberg Kelly

Purpose: This section will assist in determining whether an individual is eligible for Medicaid benefits under Goldberg Kelly.


Current Policy Effective Date: September 1, 2010

Date Last Reviewed: March 31, 2010

Previous Policy: October 1, 2009

POL M1005C: DETERMINING ELIGIBILITY FOR GOLDBERG KELLY

1. SSA Determines Goldberg Kelly Eligibility

SDX shows eligibility with a Medicaid eligibility code of “G.”

2. Applicants Potentially Eligible Under Another Medicaid Coverage Group

If the SDX shows a Medicaid test indicator code “S,” determine if the applicant is eligible under another Medicaid coverage group.

Reference:

Defining Group: 42 CFR 435.120

Clarifying Information:

1. Goldberg Kelly is defined as a Supreme Court decision requiring a client be given written notice prior to reduction, suspension or termination of SSI.

2. SSI payments will continue at the previous rate when a timely appeal is filed. These payments will continue until a decision is made.

3. These individuals are eligible for Medicaid benefits and are authorized through the SDX.

Worker Responsibilities:

Determining Eligibility When Clients on SDX With Test Indicator Code “S”

1. Require an DHCF-300 Disability Application.

2. Determine eligibility under another Medicaid coverage group.