532           SSISupplemental Security Income OR APAAdult Public Assistance INELIGIBLE FOR REASONS THAT DO NOT APPLY TO MEDICAID

Medicaid is available to an individual who would be eligible for SSISupplemental Security Income /APAAdult Public Assistance except that they do not meet an SSISupplemental Security Income /APAAdult Public Assistance rule that is specifically prohibited in the Medicaid program.

Example:

Mr. Gibson has been determined disabled by the State Disability Determination Service ( DDS ) and meets APAAdult Public Assistance financial eligibility criteria.  However, he chooses not to apply for SSISupplemental Security Income. Because pursuit of SSISupplemental Security Income is not required for Medicaid-only cases, Mr. Gibson may be determined eligible for Medicaid.

These individuals, including low-birth weight infants, must still meet APAAdult Public Assistance criteria for blindness, disability, or age.

532 A.      LOW BIRTH WEIGHT INFANT

Before a low-birth weight infant can be found eligible for APAAdult Public Assistance-related Medicaid, a DDSDisability Determination Service determination of presumptive disability must be made.

532 B.      QUALIFIED ALIEN

This category should be used for a qualified alien who lost SSISupplemental Security Income because of his or her alien status under the Personal Responsibility and Work Opportunity Reconciliation Act of 1996.  This category cannot be used for non-qualified aliens.  See APAAdult Public Assistance Manual Section 421-10.

532 C.  QUALIFYING INCOME TRUSTS

An individual who meets all other SSISupplemental Security Income or APAAdult Public Assistance eligibility requirements, except for excess income may qualify for Medicaid-only by limiting their countable income using a Qualifying Income Trust.  See Section 526.

532 D.      EIS INFORMATION