Supplemental Security Income (SSI) Retroactive Medicaid Eligibility

Supplemental Security Income (SSI) Retroactive Medicaid Eligibility A. The month Supplemental Security Income (SSI) payments begin is the SSI application effective date. It is the month following the month the SSI application is filed or the month the individual becomes eligible for SSI, whichever is later. B. Medicaid eligibility begins with the month the SSI benefit payment begins. C. The gap month created by the SSI application effective date and the SSI application month is a month in which the individual is eligible for SSI but does not receive a SSI payment. If SSI transmits data to show the individual is eligible, Medicaid eligibility is granted for this gap month. D. The SSI retroactive period is the third (3rd) month before the month the SSI application was filed. E. The SSI applicant must file a separate application for Medicaid coverage for the SSI retroactive period. Any intervening month(s) of SSI ineligibility that occurred prior to the SSI application effective date can be included in the request for retroactive coverage. F. SSI retroactive eligibility is determined using SSI rules; however, Medicaid rules are used to place the applicant in a Medicaid-only category of eligibility under which the applicant is eligible if SSI rules fail to allow eligibility in the retroactive period.