2115 Disabled Adult Child (Public Law 99-643)

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Georgia Division of Family and Children Services
Medicaid Policy Manual

Policy Title:

Disabled Adult Child (Public Law 99-643)

Effective Date:

February 2020

Chapter:

2100

Policy Number:

2115

Previous Policy Number(s):

MT 15

Updated or Reviewed in MT:

MT-58

Requirements

Disabled Adult Child (PL 99-643) is a class of assistance (COA) that provides Medicaid for an individual age 18 or over who had his/her SSI terminated on or after 7/1/87 because of entitlement to or an increase in RSDI income received as a disabled adult child.

Basic Considerations

To be eligible under the Disabled Adult Child COA, the A/R must meet the following conditions:

  • The A/R is currently receiving RSDI as a disabled adult child.

  • The A/R previously received SSI that was terminated on or after 7/1/87 because of an increase in or initial entitlement to RSDI as a disabled adult child. The increase or initial entitlement must have been on RSDI (Title II) income, not RRR or other income

  • The A/R is eligible for SSI if the initial entitlement to RSDI, any increase(s) in RSDI and/or RSDI COLAs received since the A/R last received SSI are disregarded.

  • The A/R meets all basic and financial eligibility criteria.

Length of Stay (LOS) and Level of Care (LOC) are not requirements for this COA.
The RSDI claim number will end with a beneficiary identification code (BIC) that includes C if the A/R receives RSDI as a disabled adult child.

Approve Medicaid on the system using the Disabled Adult child COA if the A/R meets all the above eligibility criteria, including retroactive months if needed.

Do not approve Medicaid using the Disabled Adult Child COA for any month for which the A/R was eligible for and received an SSI payment.

Procedures

Follow the steps below to determine Medicaid eligibility under the Disabled Adult Child COA.

Step 1

Accept the A/R’s Medicaid application.
Step 2

Conduct an interview.
Step 3

Obtain verification from SSA to verify the following:

  • The date SSI benefits were terminated.

  • The current amount of the A/R’s RSDI disabled adult child benefit.

  • The amounts of the RSDI initial entitlement, increase or COLA that caused SSI termination and all RSDI increases received since SSI was terminated.
Step 4

Determine all basic eligibility criteria except LOS and LOC. Refer to Chapter 2200, Basic Eligibility Criteria.
Step 5

Determine financial eligibility using the current SSI income and resource limits. Refer to Chapter 2500, ABD Financial Responsibility and Budgeting to determine the following:

  • Whose income and resources to consider

  • Which SSI income and resource limit (individual or couple) to use

  • Which eligibility budget to complete.
Step 6

Determine the A/R’s countable income by disregarding the following amounts of RSDI income:

  • The initial entitlement to or increase in RSDI as a disabled adult child or an increase in RSDI income that caused SSI termination

    OR

  • The RSDI disabled adult child COLA that caused SSI termination

    AND

  • All subsequent increases in RSDI. This would include COLAs as well as RSDI increases due to a change in the parents' circumstances, such as retirement and/or death. The only RSDI increase that would not be subject to disregard would be an increase due to the DAC’s own work record.
Step 7
The RSDI claim number will end with a beneficiary identification code (BIC) that includes C if the A/R receives RSDI as a disabled adult child.

Approve Medicaid on the system using the Disabled Adult child COA if the A/R meets all the above eligibility criteria, including retroactive months if needed.

Do not approve Medicaid using the Disabled Adult Child COA for any month for which the A/R was eligible for and received an SSI payment.