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 in a DPADivision of Public Assistance office. There are some APAAdult Public Assistance policies that do not apply to Medicaid. For example, Medicaid eligibility may begin based on the month of application, and does not follow APAAdult Public Assistance policies on when APAAdult Public Assistance 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 APAAdult Public Assistance 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 APAAdult Public Assistance on or after July 1, 2004, eligibility for APAAdult Public Assistance cannot begin until October 1. However, Medicaid eligibility may begin July 1, 2004, the month that the application was received in the DPADivision of Public Assistance office.

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.