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.
Defining Group: 42 CFR 435.120
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.
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.