SI NY01730.005 (New Jersey) — Medicaid Qualifying Trusts (TN 435 - 05/2013)

When an individual residing in a section 1634 State has a Medicaid trust, SSA determines if the trust is countable for SSI purposes. The existence of a Medicaid trust results in a referral to the Medicaid State agency for a Medicaid eligibility decision. See SI 01730.048 for the definition of Medicaid trusts and procedures to determine if a trust is countable for SSI purposes.

When a case with a trust or SLD is sent to the State, the FO must complete the MSSICS ROTH screen per MSOM MSSICS 013.011C or in the paper environment input a "Q" in the PT field of the SSR per POMS SM 01005.350 . Once the case is referred to the State, they will make a determination as to whether the recipient can receive Medicaid.

 

The FO should make a photocopy of the trust or SLD and mail it under cover of Exhibit I to the address below. The claimant should also be provided with a copy of Exhibit I for the claimant's records.

EX.1 - (New Jersey) Medicaid Qualifying Trust Lead

TO:    Catherine Gancarz

           NJ Division of Medical Assistance and Health Services

           Office of Legal and Regulatory Affairs

           Building 7-2nd Floor, Mail Code 5

           P.O. Box 712

          Trenton, NJ 08625

             

FROM:  _____________________________________________

                                        (SSA Office)

              ______________________________________________

              ______________________________________________

NAME:  ______________________________________________

                                      (SSI Applicant)

SSN: _________________________________________________

                                     (Social Security Number)

 

The above-mentioned individual filed for Supplemental Security Income on ______________.

_____ Attached is a copy of the trust or SLD that the person had with them when they filed at the Social Security Office.

_____ We did not enclose a copy of the trust or SLD because the person did not have it with them when they were in the Social Security office.

(CHECK ONE)

SSA Employee:  ____________________________________________

Telephone:        _____________________________________________

Date:                _____________________________________________