480-5        SUSPENSION AND TERMINATION

480-5 A.   SUSPENSION

If a recipient becomes ineligible for assistance, and it appears that the period of ineligibility will not exceed three benefit months, the APAAdult Public Assistance case will be suspended.  A period of suspension may not exceed three months.  Assistance shall be reinstated without a new application if eligibility is again found to exist at any time during the suspension period, or for the month following the suspension period.  Benefits for the month following the month of suspension begin the 1st of the next eligible month and are not prorated

During a suspension period, a recipient may sometimes remain eligible for Medicaid even though he or she is not eligible for an APAAdult Public Assistance payment.  Medicaid eligibility exists for any month(s) during a period of suspension in which the recipient continues to receive an SSISupplemental Security Income payment.  This is true even if the Social Security Administration later determines that the recipient was not eligible for the SSISupplemental Security Income payment.  See Aged, Disabled and Long Term Care (ADLTCAged, Disabled and Long Term Care Manual) Medicaid Manual Section 530.

Note:

If we become aware that an APAAdult Public Assistance recipient’s SSISupplemental Security Income benefits have been suspended using code “S06 Address Unknown,” and it appears likely that the individual’s SSISupplemental Security Income benefits may be re-instated within three months, we may suspend the APAAdult Public Assistance benefits for up to three months and continue to issue the Medicaid benefits on the same case number. Since SSISupplemental Security Income is not an eligibility factor for Medicaid, the individual’s Medicaid benefits may continue as long as the individual is otherwise eligible.  If the recipient’s SSISupplemental Security Income suspension ends, and SSISupplemental Security Income benefits are reinstated, APAAdult Public Assistance must also be reinstated.

If it subsequently appears that the individual’s SSISupplemental Security Income benefits will not be reinstated within the three-month APAAdult Public Assistance suspense period, the APAAdult Public Assistance case must be closed with a 10-day adverse action notice at the end of the three month period.  

480-5 B.   TERMINATION

If a recipient becomes ineligible for assistance and it appears that the period of ineligibility will exceed three months, or is of uncertain or indefinite duration, APAAdult Public Assistance assistance will be terminated.  The individual must reapply for assistance on DPADivision of Public Assistance form GEN 50CApplication for Services and provide any other necessary documentation and/or verification to again become eligible for assistance.

Note:

 If APAAdult Public Assistance eligibility ends, the caseworker must close the APAAdult Public Assistance case, but continue Medicaid while the individual is receiving SSISupplemental Security Income. (See ADLTC MS 530 A)