Federal Law on Medicaid Continuation After Disabled Adult Child Eligibility

Click here for the federal statute and the SSA POMS providing that Medicaid eligibility should continue for an SSI recipient who loses eligibility as a result of increased monthly income due to eligibility for Disabled Adult Child benefits.  The document is courtesy of Florida ASNP member David Lillesand.

Normally a disabled person loses Medicaid benefits when SSI is terminated. However, Congress created a special exception to this general rule [Section 1634(c) of the Social Security Act], requiring the states to continue Medicaid if a person who was receiving SSI and Medicaid loses the SSI due to an increase in his or her monthly income due to new eligibility for Disabled Adult Child benefits under Title II of the Social Security Act. (A disabled adult child becomes eligible for Title II Social Security Disability Insurance Benefits on one of his parent’s Social Security record when he has a parent who is deceased, retired, or disabled.)

The attached federal statute and the SSA POMS (see POMS SI 01715.015 Special Groups of Former SSI Recipients, paragraph B.4.) direct that an adult disabled child in this category is regarded as a member of a “special group of former SSI recipients” who may keep their Medicaid benefits even though they lose their SSI. The attachment also includes the State of Florida’s ESS Manual section requiring the state to follow federal law.