Special Medicaid Eligibility for Childhood Disability Beneficiaries (CDBs): When Medicaid Continues Upon Loss of SSI Due to CDB Eligibility or an Increased CDB Payment Amount
Description: The article details how individuals who lose Supplemental Security Income (SSI) due to establishing eligibility for or receiving an increase in Social Security Childhood Disability Benefits (CDB) can maintain their Medicaid coverage under Section 1634(c) of the Social Security Act.
Introduction
The Supplemental Security Income (SSI) program pays a monthly cash benefit, in all states, to persons with disabilities with limited income and resources based on a Federal Benefit Rate (FBR), $841 in 2022, and an optional State Supplement (SSP). In all States as countable income increases, the monthly SSI/SSP payment amount decreases. SSI payments will be suspended when countable income is equal to or more than a State’s maximum SSI rate, based on the person’s living arrangement.
In 42 States, the District of Columbia, and the Northern Mariana Islands, a person eligible for any amount of SSI per month is automatically eligible for Medicaid. Most of those States, known as “section 1634 States,” automatically enroll these individuals in Medicaid without the need for a separate application. In seven of those States (Alaska, Idaho, Kansas, Nevada, Nebraska, Oregon, Utah) and the Northern Mariana Islands, known as “SSI Criteria States,” the person is required to separately apply for Medicaid and that application will be automatically approved. In the eight section 209(b) States (Connecticut, Hawaii, Illinois, Minnesota, Missouri, New Hampshire, North Dakota, Virginia), SSI beneficiaries are not automatically eligible for Medicaid and their Medicaid eligibility is determined by rules set up for each State, that are typically more restrictive than the SSI rules. Social Security Program Operations Manual System (POMS) SI 01715.010 A, https://secure.ssa.gov/apps10/poms.nsf/lnx/0501715010.
Ordinarily, when a person’s countable income is enough to reduce the SSI payment to
$0, the right to an SSI payment will be suspended and could be terminated after 12 consecutive months of ineligibility for an SSI payment or ineligibility for the 1619(b) Medicaid work incentive. The right to automatic Medicaid, in the 1634 and SSI Criteria States would also be suspended. In that case, the State’s Medicaid program will be required to determine whether the person could be found eligible for continued Medicaid under a separate category of Medicaid eligibility.(1) This article will describe four separate categories of special Medicaid eligibility for former SSI beneficiaries that will allow automatic Medicaid to continue after a loss of SSI due to excess income. We will then focus on one of the four categories – special eligibility for a person whose SSI is suspended or terminated upon eligibility for Social Security Childhood Disability (CDB) payments or upon receipt of an increased CDB payment amount.
Special Medicaid Eligibility Categories for Former SSI Beneficiaries
These are sometimes referred to as “deemed SSI” categories, as the beneficiary is treated for Medicaid eligibility purposes as if they were still eligible for SSI. POMS SI 01715.015, https://secure.ssa.gov/apps10/poms.nsf/lnx/0501715015. Importantly, whenever the terms “SSI program” or “SSI benefits” are used in the context of the Special Medicaid Beneficiaries discussion, this means the person “may either be receiving cash benefits under Title XVI [i.e., SSI or SSP] or be a 1619(b) participant (receiving Medicaid benefits, but not cash benefits). Individuals in either of these categories are considered to be receiving SSI benefits and are eligible to participate in the groups described in this letter.” Groups Deemed to be Receiving SSI for Medicaid Purposes (Centers for Medicare and Medicaid Services, June 12, 2002), https://www.hhs.gov/guidance/sites/default/files/hhs-guidance-documents/2002.groups%2520deemed%2520to%2520be%2520receiving%2520ssi%2 520for%2520medicaid%2520purposes_2.pdf.
When we refer to SSI or loss of SSI benefits, in the Special Medicaid eligibility discussion below, readers can assume that 1619(b) is included per the CMS policy referenced above. However, since we understand no state has referenced the loss of 1619(b) eligibility in its special rules for Childhood Disability Beneficiaries, we will not discuss this issue again until the end of the CDB discussion.
Special Medicaid eligibility determinations for Pickle, Disabled Widows/Widowers, and Childhood Disability Beneficiaries are made by the State Medicaid agency or its designee. The Social Security Administration (SSA) makes 1619(b) eligibility determinations.
Pickle Amendment: Not SSI Eligible Due to Social Security Cost-of-Living Increases
This protects automatic Medicaid eligibility for persons who would continue to receive federal SSI and/or an SSP, if not for cost-of-living adjustments (COLAs) or increases in their Social Security payment amount (applies to Social Security Retirement, Survivors, and Disability Insurance payments).
The State’s Medicaid agency (or its designee) will determine whether the person meets the three-part eligibility test:
They are currently receiving Social Security benefits;
They were simultaneously entitled to both Social Security payments and an SSI or SSP payment for at least one month after April 1, 1977; and
They lost SSI and/or SSP eligibility but would still be eligible for that benefit if the Social Security COLAs they received since losing the SSI or SSP were deducted from their income.
See 42 CFR 435.135; POMS SI 01715.015 B.2.; and A Quick and Easy Method of Screening for Medicaid Eligibility under the Pickle Amendment, https://healthlaw.org/resource/a-quick-and-easy-method-of-screening-for-medicaid-eligibility-under-the-pickle-amendment-2022-update/ (two-page document provides explanation of Pickle eligibility and a chart to screen for Medicaid eligibility under Pickle).
If the State Medicaid agency uses SSI criteria in determining eligibility (i.e., in 1634 and SSI-criteria States), it must disregard all of the relevant Social Security benefit increases in determining Medicaid eligibility under Pickle. In the eight section 209(b) States, however, the State has the option of disregarding all, part, or none of the relevant COLAs. See Groups Deemed to be Receiving SSI for Medicaid Purposes, above, p. 2.
Disabled Widow/Widower Beneficiaries
The person who loses the right to an SSI or SSP payment because they are now eligible for Social Security Widow’s or Widower’s benefits can retain the right to automatic Medicaid for up to 24 months while they await future eligibility for Medicare Part A. 42 CFR 435.137; POMS SI 01715.015 B.2.
To retain Medicaid under this provision the person must establish:
They received an SSI or SSP payment the month before their Social Security Widow’s/Widower’s payments began;
They would continue to be eligible for SSI or SSP if their Widow’s/Widower’s benefits are ignored; and
They are not currently entitled to Medicare Part A.
For individuals who qualify as Disabled Widows/Widowers, all States (including 209(b) States) must disregard all the Social Security benefits that make the individual ineligible for SSI. See Groups Deemed to be Receiving SSI for Medicaid Purposes, above, p. 2.
Section 1619(b) Medicaid
This special work incentive allows former SSI beneficiaries to be treated as receiving SSI when they lose the right to an SSI payment based on countable earned income, if they would still be eligible for an SSI or SSP payment if their countable earned income is ignored, and if their annual income is less than a specified State income threshold. POMS SI 02302.010C, https://secure.ssa.gov/apps10/poms.nsf/lnx/0502302010 (laying out 1619(b) eligibility requirements). “In order to continue Medicaid eligibility, section 1619(b) participants are deemed by law to be receiving an SSI payment for Medicaid purposes.” POMS SI 01715.015 B.1.
Childhood Disability Beneficiaries
The fourth special Medicaid beneficiary category, covering Childhood Disability Beneficiaries (CDBs), is the focus of this article and is covered in great detail below.
We will not provide additional details on the Pickle Amendment or Disabled Widow/Widower categories. For a more thorough discussion of those topics, see Special Medicaid Beneficiaries (Virginia Commonwealth University, WIPA National Training and Data Center, January 2022), https://vcu-ntdc.org/resources/WIPA_OtherResources/SpecialMedicaidBene2022.pdf. Some additional discussion of 1619(b) is laid out within the CDB discussion, below.
Special Medicaid Eligibility for Childhood Disability Beneficiaries
What are Childhood Disability Benefits?
Social Security Childhood Disability Benefits, also referred to as Disabled Adult Child (DAC) benefits, (2) are available to individuals with disabilities (a natural child, stepchild, or (in limited cases) dependent grandchild) as early as age 18. These benefits are most often paid on the earnings record of a parent who is now disabled, retired, or deceased, but can also be paid on the earnings record of a stepparent or other person in a parent-like relationship. Generally, marriage will cause CDB benefits to stop, unless the marriage is to another Social Security beneficiary (other than a Child’s Insurance Beneficiary). (3) Since a CDB payment is so often associated with the retirement or death of a parent or stepparent, many adult children will not establish CDB eligibility until their 30s, 40s, or an older age, but must still show a disability onset before age 22.
Compare: Child’s Insurance Benefits (CIB). These payments are available to dependent children through age 18 (or age 19 if still in school), based on the same dependency relationships as required for CDB but with no requirement that the child have a disability.
CDB and CIB benefits are covered in greater detail in our Deeper Dive Article #2, Transition-Aged Youth with Disabilities and Social Security Benefits, with a Focus on Childhood Disability Benefits, https://nabwis.org/docs/Deeper_Dive_02-Final_5-12-22.pdf.
Childhood Disability Benefits Payment Formulas
The amount of an adult child’s CDB payments can be:
Up to 50 percent of the parent’s/stepparent’s/grandparent’s Social Security benefit (“primary insurance amount” or PIA) if the parent is alive and getting SSDI or Social Security Retirement benefits.
Up to 75 percent of the PIA if the parent/stepparent/grandparent is deceased.
If one or more additional dependents is paid from the parent’s/stepparent’s/grandparent’s Social Security record, the adult child will share the 50 or 75 percent (or a lower amount) with the other dependent(s).
The same formula is applied to CIB payments. POMS RS 00203.025 A, https://secure.ssa.gov/apps10/poms.nsf/lnx/0300203025. Our examples below will be based on either 50 or 75 percent of the parent’s PIA, even though actual CDB or CIB payments could be at a lower amount based on a complicated formula.
Special Medicaid Eligibility for CDBs: the Basics
Section 1634(c) of the Social Security Act, 42 US Code 1383c(c), requires States to continue Medicaid for Childhood Disability Beneficiaries who lose SSI upon eligibility for CDB or an increase in the CDB payment amount if the person would have remained eligible for SSI if not for the CDB entitlement or increase.
To be eligible for this special Medicaid benefit the person:
Must be at least age 18;
Had been eligible for SSI or SSP and, on or after July 1, 1987, lost the right to SSI or SSP because of entitlement to a CDB payment or an increased CDB payment amount; and
Would have remained otherwise eligible for SSI/SSP but for their entitlement to the CDB payment or an increase in the CDB payment amount.
If the State Medicaid agency uses SSI criteria in determining eligibility (i.e., 1634 and SSI-criteria States), it must disregard all of the relevant CDB Social Security benefit amounts or increases in determining Medicaid eligibility. In the eight section 209(b) States, however, the State has the option of disregarding all, part, or none of the relevant COLAs.(4)
Example 1 – SSI Lost Upon Entitlement to CDB
Nilda, age 34, was approved for SSI at age 18 and was getting an SSI payment of $841 in 2022 (FBR with no optional SSP) and automatic Medicaid (lives in a 1634 state). Her mother died in July 2022. She had a PIA of $1,600 per month. Nilda then qualified for CDB payments of $1,200 per month (75 percent of her mother’s PIA). With countable income of $1,180 per month, Nilda will no longer be eligible for an SSI payment.
Nilda will qualify for continued Medicaid as a Childhood Disability Beneficiary. She meets the CDB Medicaid criteria: is at least 18; had been eligible for an SSI payment, but lost SSI because of entitlement to CDB payments; and would remain “otherwise eligible” for SSI payments since we will ignore her full CDB payment (as a person initially entitled to CDB).
CDB Medicaid “Otherwise Eligible for SSI” Monthly Calculation for Nilda
Countable unearned income = $0 ($1,200 CDB fully excluded)
Countable earned income = $0
Total countable income = $0
With countable income reduced to $0, Nilda would be otherwise eligible for an SSI payment and thus is eligible for continued Medicaid under the CDB rules.
Example 2 – SSI Lost Upon Increase in CDB Payment (Parent Dies)(5)
Aden qualified for SSI payments at age 18 in a state that pays the FBR with no SSP. When Aden was 23 (in 2020), his father began receiving SSDI of $1,350 per month and Aden was awarded CDB of $675 per month (50 percent of his father’s PIA), with SSI reduced to $128 per month ($783 – 655). As 2022 began, the father’s SSDI had increased to $1,400 per month and Aden’s CDB payment was now $700 per month.
With $680 in countable income, after a $20 general income exclusion, Aden’s SSI payment for 2022 was set at $161 ($841 – 680). Since Aden lived in an SSI Criteria State, he was able to qualify for automatic Medicaid.
In September 2022, Aden’s father died, and Aden was awarded a higher CDB amount of $1,050 (75 percent of the father’s PIA). Since Aden’s increased countable income of
$1,030 per month, after a $20 exclusion, is more than his state’s $841 SSI rate, Aden is no longer eligible for an SSI payment.
Aden will qualify for continued Medicaid as a Childhood Disability Beneficiary. He meets the CDB Medicaid criteria: is at least 18; had been eligible for an SSI payment, but lost SSI because of an increase to his CDB payment rate; and would remain “otherwise eligible” for SSI payments since we will ignore the 2022 increase to his CDB payment.
CDB Medicaid “Otherwise Eligible for SSI” Monthly Calculation for Aden
Countable unearned income = $680 ($1,050 – 350 CDB increase - 20)
Countable earned income = $0
Total countable income = $680
With countable income reduced to $680, Aden would be otherwise eligible for an SSI payment of $161 ($841 – 680) and thus is eligible for continued Medicaid under the CDB rules.
Example 3 – Increase in CDB Payment (Second Beneficiary no Longer Eligible).
Lars qualified for SSI at age 18 in a state that pays the FBR with no SSP. In 2019, when Lars is 23 his mother retires and begins collecting Social Security Retirement (SSR) benefits. Lars then qualifies for CDB, plus a reduced SSI payment, and his sister, Amy, at age 15 qualifies for CIB benefits. As 2022 begins, the mother’s new SSR rate is
$2,000 per month. Lars and Amy each now qualify for monthly payments of $500 for CDB and CIB respectively (a combined total of 50 percent of their mother’s PIA). Lars now qualifies for SSI of $361 per month based on $480 of countable CDB after a $20 general income exclusion ($841 – 480). Lars continues to qualify for automatic Medicaid based on receipt of SSI (he resides in a 1634 State).
Lars’ sister Amy turns 18 in April 2022. When she graduates from high school in June 2022, her CIB will stop as CIB benefits end when she graduates from high school as an 18-year-old.(6) Since Lars will no longer share dependents benefits with his sister (she is not a candidate for CDB as she does not have a disability), his CDB now increases to
$1,000 per month (a full 50 percent of his mother’s PIA). With $980 of countable CDB, after a $20 exclusion, Lars no longer qualifies for an SSI payment and without SSI would not ordinarily be eligible for automatic Medicaid.
Lars will qualify for continued Medicaid as a Childhood Disability Beneficiary. He meets CDB Medicaid criteria: is at least 18; had been eligible for an SSI payment, but lost SSI because of an increase to his CDB payment rate; and would remain “otherwise eligible” for SSI payments since we will ignore the 2022 increase to his CDB payment.
CDB Medicaid “Otherwise Eligible for SSI” Monthly Calculation for Lars
Countable unearned income = $480 ($1,000 – 500 CDB increase - 20)
Countable earned income = $0
Total countable income = $480
With countable income reduced to $480, Lars is otherwise eligible for an SSI payment of $361 ($841 – 480) and thus is eligible for continued Medicaid under CDB rules.
How CDB Medicaid Eligibility is Implemented at the State Level
SSA notifies the 1634 states about potential members in the CDB Medicaid eligibility group through an electronic communication system known as the State Data Exchange (SDX). Since approximately May 1995, SSA sends beneficiaries, in all States, an “automated Notice of Planned Action” if the beneficiary:
is at least 18;
loses SSI due to excess income in a month of Social Security entitlement; and
“the SSI computer record reflects [Social Security] continuing income with a Beneficiary Identification Code (BIC) of ‘C’.”
POMS NL 00804.110 section 1140,
https://secure.ssa.gov/apps10/poms.nsf/lnx/0900804110. The notice’s language alerts beneficiaries they may be eligible for continued Medicaid under special rules.
What happens after the Medicaid agency in the 1634 State gets the SDX communication or after the Medicaid beneficiary gets the SSA notice? Based on the co-authors’ experience with a 1990s New York class action, the most optimistic answer in 1634 states is that an experienced Medicaid worker sees the codes in the SDX, identifies the case as potential CDB Medicaid, and determines eligibility for continued Medicaid under the CDB rules. Unfortunately, the CDB Medicaid cases are low in number, and many Medicaid workers may never have made an eligibility decision under these rules – and will only consider other, non-CDB categories of Medicaid eligibility, such as the spend down (i.e., share of cost) category that exists in many states.
SSA’s Notice of Planned Action, sent to all who lose SSI under these circumstances may help. However, it shifts the onus of action to the beneficiary who may already be overwhelmed and may not understand the notice. The reality is that benefits counselors who read this article may be best equipped to help beneficiaries pursue their rights to special CDB Medicaid eligibility.
The Unique Interplay Between 1619(b) and CDB Medicaid
Loss of 1619(b) is Considered a Loss of SSI
Section 1619(b) is an extremely important provision of the Social Security Act as it protects not only individuals’ Medicaid coverage, but also maintains their eligibility to receive SSI cash benefits in future months when countable income falls below the allowable limits. This protection is provided only when individuals continue to meet all other eligibility requirements for SSI. As 1619(b) status maintains an active SSI case for an indefinite time period, individuals may work for several years above the allowable levels for SSI cash benefits. They will be reinstated to SSI cash payments automatically if they stop working or if reduced earnings fall below the allowable levels.
Individuals will only be eligible to move into 1619(b) status if the reason for SSI cash benefit suspension is due to excess earned income. If individuals are no longer 1619(b) or SSI eligible due to any other non-disability requirement (e.g., resources exceed the
$2,000 limit), their eligibility will be suspended until the next month in which all eligibility requirements for either SSI or 1619(b) are met. Individuals enter a 12-month suspension period, which begins with the first month the benefits should have been suspended regardless of when SSA actually takes the suspension action. If all eligibility requirements for SSI or 1619(b) are again met within 12 months following the first month of ineligibility, individuals may be reinstated without filing new applications for SSI. After 12 consecutive months of ineligibility a termination will occur and a new application for SSI must be filed to reestablish SSI eligibility. This involves a new disability determination, including a substantial gainful activity determination.(7)
If Other CDB Medicaid Criteria Met, Automatic Medicaid Continues if Person Would Still be 1619(b) Eligible but for CDB Eligibility or Increase in CDB.
Note: This discussion assumes the enforceability of the policy stated in the 2002 CMS technical assistance paper to States, discussed above. Extra efforts may be needed in all States, and at a national level, to get that policy enforced.
To be eligible for this CDB Medicaid benefit the person must be at least age 18; had been eligible for SSI, SSP, or 1619(b) Medicaid, and lost the right to SSI, SSP, or 1619(b) because of entitlement to a CDB payment or an increased CDB payment amount; and would have remained otherwise eligible for SSI/SSP/1619(b) but for their entitlement to the CDB payment or an increase in the CDB payment amount.
Example 4: Let’s go back to Lars’ Case
As stated above, Lars qualified for SSI at age 18 in a State that pays the FBR with no SSP. In 2019, when Lars is 23 his mother retires and begins collecting Social Security Retirement (SSR) benefits. Lars then qualifies for CDB, plus a reduced SSI payment, and his sister, Amy, at age 15 qualifies for CIB benefits.
As 2022 begins, the mother’s new SSR rate is $2,000 per month. Lars and Amy each now qualify for monthly payments of $500 for CDB and CIB respectively. Lars now qualifies for SSI of $361 per month based on $480 of countable CDB after a $20 general income exclusion ($841 – 480).
In March 2022, Lars gets a job that pays him $1,065 a month. His $500 in countable earnings ($1,065 – 65 = 1,000/2), combined with his $480 countable CDB payment ($500 - 20), give him $980 in countable income and cause his SSI to be reduced to $0. However, he remains eligible for Medicaid pursuant to the 1619(b) criteria.
When Lars’ sister Amy graduates from high school in June 2022, at age 18, her CIB will stop. Since Lars will no longer share dependents benefits with his sister, his CDB now increases to $1,000 per month. With $980 of countable CDB, after a $20 exclusion, Lars no longer qualifies for 1619(b). Since his $980 of countable unearned income alone would make him ineligible for SSI, he is no longer eligible for 1619(b). Without 1619(b) he would not ordinarily be eligible for automatic Medicaid.
Lars will qualify for continued 1619(b) Medicaid as a Childhood Disability Beneficiary. He meets the CDB Medicaid criteria: he is at least 18; had been eligible for 1619(b) Medicaid but lost that eligibility because of an increase in CDB payments; and would remain “otherwise eligible” for 1619(b) Medicaid if we ignore 2022’s $500 increase to his CDB payment.
Readers should be aware there may be any number of other scenarios where, by reading the CDB Medicaid and 1619(b) protections together, a beneficiary will be eligible for continued Medicaid as if still SSI or 1619(b) eligible.
Reality Check: Based on the authors’ limited review of State CDB Medicaid policy, we have found no state that includes in its policy a discussion of loss of 1619(b) through CDB eligibility or increase. Two of our colleagues researched the CDB Medicaid policies in all States and concluded that no State includes the 1619(b) loss due to CDB in its policy. For this reason, we believe the 1619(b) related cases will require extra advocacy efforts to ensure continued Medicaid and possibly an administrative hearing or litigation to resolve the issue.(8) Advocacy at the federal level will also be needed to encourage CMS to issue a Medicaid policy that is much more specific than what is covered in their 2002 technical assistance paper.
Suggested Strategies When CDB Medicaid Eligibility is Not Implemented at the State Level
As stated earlier, section 1634(c) provides for continued Medicaid eligibility for many former SSI recipients who are receiving CDB. Based on the authors’ 1990s litigation experience in New York – documenting roughly 1,000 statewide cases per year where the CDB-related code appeared in the SDX -- we believe that tens of thousands of new potential CDB Medicaid cases occur nationwide each year. Despite the clear importance of this law for people with disabilities, more than 35 years after its enactment many people with disabilities are not receiving the full Medicaid coverage to which they are entitled. It is important for benefits counselors who work with people with disabilities to be aware of this relatively little-known law and to ensure its full implementation in their State.
Caution: Things to Remember About CDB Medicaid
Here are some key things readers need to know about CDB Medicaid:
Expect a new eligibility analysis, by the State Medicaid agency every year.
During the periodic eligibility review, the beneficiary must show they are “otherwise eligible for SSI,” after excluding CDB payments/increases since last eligible for SSI and/or SSP.
There is no time limit to establish CDB Medicaid eligibility. If eligibility is discovered in 2022 and should have been implemented one or more years ago, special Medicaid status can still be implemented going forward.
The beneficiary’s countable resources must meet SSI’s $2,000 limit, even if the State-specific Medicaid resource limit is higher.
Other income could make the person not “otherwise eligible” – such as deemed income from a spouse, or periodic payments from a pension, IRA, or 401K.
Conclusion
Systemic advocacy is essential in many States to correct any lack of application of this special Medicaid continuation rule. If your funding source and supervisor allow this type of work and you can devote the time to it, this can be some of the most effective and satisfying work a benefits counselor performs. If you are successful at getting a State agency to apply the special CDB Medicaid protections, your work can impact hundreds and possibly thousands of individuals who might otherwise be harmed by the non-application of the special CDB Medicaid protections.
Here are a couple of advocacy strategies to make positive changes in your State. First, there is a very good chance that others in your State’s advocacy community are involved in this type of work. Find out who they are and reach out to them. Second, the Medicaid agency responsible for applying the special CDB Medicaid protections may have created a system you can use to alert them to problems with policy implementation. Consider using that system. Ultimately, you want to find a path to the person or persons most likely to facilitate a change that will result in Medicaid decision makers applying the policy.
Many benefits counselors will encounter the special CDB Medicaid protections in their work. It may be enough, in some States, to just make sure the Medicaid worker is alerted to the relevance of the CDB Medicaid protections to the person you serve. We urge you to help identify any of the barriers to application of the special CDB Medicaid protections, in your State, and play whatever role you can to eliminate them on a systemic level. And let us know about your efforts and successes.
Dated: September 21, 2022
Authors: James R. Sheldon, JD (Board Member), Disability Consultant and Edwin J. Lopez-Soto, JD (NABWIS member), Extension Faculty, Cornell’s Yan Tan Institute (YTI)
Footnotes:
1 - 42 CFR 435.916(f)(1); POMS SI 01715,015 A.
2 - Although SSA’s preferred term in recent years is Childhood Disability Benefits many non-SSA websites, including those of many State Medicaid agencies continue to use the Disabled Adult Child (DAC) benefits designation. Even some SSA documents, including the Benefits Planning Query (BPQY), still use the DAC terminology.
3 - POMS RS 00203,020 A. If marriage is to an SSI beneficiary CDB will stop.
4 - See Groups Deemed to be Receiving SSI for Medicaid Purposes, above, p. 2 ; Congressional Research Service, Medicaid Eligibility: Older Adults and Individuals with Disabilities, pp. 17-18, https://crsreports.congress.gov/product/pdf/R/R46111 (Dec. 9, 2019).
5 - In this and other examples, the increased Social Security payment amounts are not tied precisely to actual COLAs for the years in question. Rather, we use numbers that are easier for the readers to follow.
6 - POMS RS 00203.035, https://secure.ssa.gov/apps10/poms.nsf/lnx/0300203035.
7 - Details on 1619(b) policy begin at POMS SI 02302.000.
8 - It has taken litigation in four States that we know of to enforce the Special CDB Medicaid rules for those losing SSI or SSP cash payments. This includes the authors’ 1990s litigation in New York and separate litigation in West Virginia, Florida, and Iowa.
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