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 FOR APPLICATIONS RECEIVED ON OR AFTER JULY 1, 2004

1. Applicant meets all eligibility requirements on date of application

For applicants who meet all APA eligibility requirements (including receipt of SSI Supplemental Security Income 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 Supplemental Security Income or needs a disability determination

For applicants who are not receiving SSI Supplemental Security Income or those who need a disability determination, the APA benefit start date will be the first day of the month after the Social Security Administration issues written notice of the applicant’s eligibility for SSI Supplemental Security Income or Disability Insurance benefits, or the first day of the month after the Disability Determination Service (DDS Disability Determination Service) notifies DPA that the applicant is disabled, whichever date is earlier.

Example:

On January 5, an individual applies for both APA and SSI Supplemental Security Income benefits.  On June 6, the same year, the Social Security Administration issues a notice to the applicant that he is eligible for SSI Supplemental Security Income beginning January 5.

Because Social Security notified the individual of SSI Supplemental Security Income eligibility in June, the benefit start date for APA is July 1.  

410-7 B.   INITIAL MONTH’S APA PAYMENT FOR APPLICATIONS RECEIVED BEFORE JULY 1, 2004.

APA applicants who applied before July 1, 2004 are entitled to receive APA benefits from the date on which the APA application is received in a DPA office, the date on which the applicant meets all APA eligibility requirements, or the date on which the applicant is found eligible for an SSI Supplemental Security Income benefit, whichever date is later.

Interim Assistance recipients who are approved for SSI Supplemental Security Income are eligible for APA benefits beginning with the 1st day of the month after the month SSA decides the individual is eligible for SSI Supplemental Security Income.  (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 Medical Assistance manual section 5008.