2055 Sponsored Aliens | Medicaid

Georgia Division of Family and Children Services
Medicaid Policy Manual

Policy Title:

Requirements

Aliens who are ineligible for SSI because of income or resources deemed from a sponsor may be determined eligible for Medicaid without considering the income or resources of the sponsor.

Basic Considerations

Aliens who are admitted to the United States as permanent residents often have a sponsor. The income and resources of a sponsor and his/her spouse are used by SSI in determining the financial eligibility of an alien.

The Social Security Administration (SSA) deems the sponsor’s income and resources in the SSI eligibility determination for up to five years. The five-year period begins with the month the alien is admitted to the U.S. for permanent residence or is granted permanent resident status.

SSA may waive deeming from the sponsor when the alien’s disability or blindness begins at either of the following points:

After entry into the U.S. for permanent residence
After becoming a permanent resident

The income and resources of a sponsor are not considered in Family Medicaid budgeting.

Procedures

Follow the steps below to process the Medicaid application of a sponsored alien.

Step 1

Verify the alien’s SSI application was denied based on the sponsor’s income or resources.

If the A/R is denied SSI solely due to the sponsor’s deemed income or resources, consider eligibility for Medicaid under any class of assistance, including SSI Medicaid.

Step 2

Determine eligibility for Medicaid without considering the income and resources of the sponsor. Consider retroactive and ongoing eligibility.

A reduction in the income and resources of the sponsor, the sponsor’s spouse or the A/R may make the A/R eligible for SSI. Remind the A/R and sponsor to report changes in financial circumstances.

Step 3

Verify the month SSI will stop counting the income and resources of the sponsor.

Step 4

Complete the CMD at least one month before the month SSI will stop counting the income and resources of the sponsor to determine if the alien is SSI eligible or eligible under a COA other than SSI Medicaid. Refer to 2052 Continuing Medicaid Determination.

Step 5

Obtain DMA Form 526 or a written, signed statement from the physician verifying the need for emergency medical services. The signature should be the original signature of the physician or a medically trained employee of the physician designated to act on his/her behalf. Forms using the physician’s stamped signature are not acceptable. Faxes are acceptable if the form is faxed from the physician’s office and the signature on the faxed form was original. When questionable, contact the physician’s office to verify.