Eligibility Online Manual

M1005E 1619

Purpose: This section will assist in determining whether an individual is eligible for Medicaid benefits as a 1619.


Current Policy Effective Date: September 1, 2010

Date Last Reviewed: April 5, 2010

Previous Policy: January 1, 2007

POL 1005E: DETERMINING ELIGIBILITY FOR 1619

1. Social Security Administration (SSA) Determines Eligibility

The SDX shows eligibility with a code of “A,” “B,” or “F.”

2. Applicants May Be Eligible Under Another Medicaid Coverage Group

If the SDX shows a Medicaid test indicator code of “C,” “D,” “E,” “G,” “H,” “J,” “K,” “L,” or “M” determine if the applicant is eligible under another Medicaid coverage group.

Reference:

Defining Group: 42 CFR 435.120

Clarifying Information:

1. Section 1619 of the Social Security Act provides benefits for disabled or blind individuals who are SSI eligible except for earned income.

2. 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 “C,” “D,” “E,” “G,” “H,” “J,” “K,” “L,” or “M”

1. Require an DHCF-300 Disability Application.

2. Determine eligibility under another Medicaid coverage group.