410-7 INITIAL MONTH BENEFITS
The benefit start date for APA and Medicaid benefits may vary as follows:
410-7 A. INITIAL MONTH’S APA PAYMENT
1. Applicant meets all eligibility requirements on date of application
For applicants who meet all APA eligibility requirements (including receipt of SSI benefits) on the date of application, the benefit start date will begin the date the APA application is received in a DPA office.
2. Applicant is not eligible for SSI payment or needs a disability determination at time of application
For applicants who are not receiving SSI or those who need a disability determination, the APA benefit start date will be the first day of the month after Social Security Administration awards SSI or SSDI benefits, or the first day of the month after the Disability Determination Service (DDS ) notifies DPA that the applicant is disabled, whichever is earlier.
If the applicant does not provide a copy of the Social Security award letter, eligibility staff can verify the award date with Social Security Administration. This can be done by contacting Social Security Administration directly or by utilizing the electronic interfaces.
Note:
If there is conflicting or questionable information on the interfaces, eligibility staff must request a copy of the award letter from the applicant or verify the award information with Social Security Administration.
Example 1:
On January 5, an individual applies for both APA and SSI benefits. On June 6, the same year, the Social Security Administration issues a notice to the applicant that he is eligible for SSI beginning January 5.
Because Social Security notified the individual of SSI eligibility in June, the benefit start date for APA is July 1.
Example 2:
On March 5, Aaron applies for both APA and SSI benefits. On April 12, he is approved for SSI . The Social Security Administration issues an award letter the same day. The eligibility worker receives an alert on September 1 showing the client is in pay status with SSI . The worker contacts the Social Security office and verifies the award letter was issued on April 12.
Because Social Security notified the individual of SSI eligibility in April, the benefit start date for APA is May 1.
410-7 B. INITIAL MONTH’S APA PAYMENT FOR INTERIM ASSISTANCE RECIPIENTS
Interim Assistance recipients who are approved for SSI are eligible for APA benefits beginning with the 1st day of the month after the month SSA decides the individual is eligible for SSI . (Refer to section 426-7A.)
410-7 C. ELIGIBILITY FOR MEDICAID
If otherwise eligible, APA applicants may qualify for Medicaid coverage back to the month that an APA application is received in a DPA office. There are some APA policies that do not apply to Medicaid. For example, Medicaid eligibility may begin based on the month of application, and does not follow APA policies on when APA payments begin. To qualify for Medicaid coverage, these persons must still meet all other eligibility factors, including blindness, disability, or age.
Example: APA and Medicaid benefits begin in different months
An applicant applies for APA and related Medicaid on July 15, 2004. On September 10, the Social Security Administration notifies the applicant that he is eligible for Social Security Disability Insurance benefits of $600 per month beginning with the benefit month of July.
Because the applicant applied for APA on or after July 1, 2004, eligibility for APA cannot begin until October 1. However, Medicaid eligibility may begin July 1, 2004, the month that the application was received in the DPA office.
410-7 D. RETROACTIVE MEDICAID COVERAGE
An APA applicant may be eligible for Medicaid benefits for one or more of the three months before the month that the APA application was filed. Eligibility for Medicaid under this provision is explained in MAGI Medicaid manual section 827.
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