410-7        INITIAL MONTH BENEFITS

 

The benefit start date for APAAdult Public Assistance and Medicaid benefits may vary as follows:

 

410-7 A.   INITIAL MONTH’S APAAdult Public Assistance PAYMENT

 

1. Applicant meets all eligibility requirements on date of application

 

For applicants who meet all APAAdult Public Assistance eligibility requirements (including receipt of SSISupplemental Security Income benefits) on the date of application, the benefit start date will begin the date the APAAdult Public Assistance application is received in a DPADivision of Public Assistance office.

 

2. Applicant is not eligible for SSISupplemental Security Income payment or needs a disability determination at time of application

 

For applicants who are not receiving SSISupplemental Security Income or those who need a disability determination, the APAAdult Public Assistance benefit start date will be the first day of the month after Social Security Administration awards SSISupplemental Security Income or SSDISocial Security Disability Insurance benefits, or the first day of the month after the Disability Determination Service (DDSDisability Determination Service) notifies DPADivision of Public Assistance 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:

On January 5, an individual applies for APAAdult Public Assistance  The application is pended for 30 days for the individual to be in pay status with SSISupplemental Security Income benefits.  On January 31 the SSASocial Security Administration issues a notice to the individual that they are eligible for SSISupplemental Security Income beginning February 1.  

Because the SSASocial Security Administration notified the individual of SSISupplemental Security Income eligibility in January, the benefit start date for APAAdult Public Assistance is February 1.

 

 

 

410-7 B.   INITIAL MONTH’S APAAdult Public Assistance PAYMENT FOR INTERIM ASSISTANCE RECIPIENTS

 

Interim Assistance recipients who are approved for SSISupplemental Security Income are eligible for APAAdult Public Assistance benefits beginning with the 1st day of the month after the month SSASocial Security Administration decides the individual is eligible for SSISupplemental Security Income. (Refer to section 426-7A.)

 

410-7 C.   ELIGIBILITY FOR MEDICAID

 

If otherwise eligible, APAAdult Public Assistance applicants may qualify for Medicaid coverage back to the month that an APAAdult Public Assistance application is received. There are some APAAdult Public Assistance policies that do not apply to Medicaid. For example, development of income requirements do not apply to Medicaid.  To qualify for Aged, or disability related Medicaid, an individual must still meet all other factors of eligibility including blindness, disability or age.  When an APAAdult Public Assistance applicant doesn't meet all factors of eligibility for Aged, or disability related Medicaid, the caseworker must always determine if an individual is eligible for another category of Medicaid such as MAGIModified Adjusted Gross Income Expansion Medicaid.  See MAGIModified Adjusted Gross Income Medicaid Manual Section 816.

 

Example:   

An applicant applies for APAAdult Public Assistance and related Medicaid on September 30, 2025.  The individual is 35 years of age, has no income, no disability determination, and is not in pay with SSISupplemental Security Income.  The individuals APAAdult Public Assistance application must be pended for the individual to apply for and be in pay with Supplemental Security Income (SSI).  The case worker determines that the individual is eligible for Medicaid in the MAGIModified Adjusted Gross Income Expansion category the month the application is received.
 

 

410-7 D.   RETROACTIVE MEDICAID COVERAGE

 

An APAAdult Public Assistance applicant may be eligible for Medicaid benefits for one or more of the three months before the month that the APAAdult Public Assistance application was filed. Eligibility for Medicaid under this provision is explained in MAGIModified Adjusted Gross Income Medicaid manual section 827.

 

 

 

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MC # 74 (12/25)