SI CHI01310.207 Medicaid Eligibility Under a State Home Care Plan (RTN 373 -- 02/2008)

A. Background

 

Section 1915(c) of the Social Security Act allows the states to develop programs for medical assistance to certain groups of individuals in order to provide them with home and community based care.

 

B. Policy

 

Disabled children who are eligible for Medicaid under one of these state home care plans may be eligible for SSI benefits under the deeming waiver provisions (Section 8010 of Public Law 101-239) provided that they meet all the requirements described in SI 01310.201.A.1.

 

C. Verification Requirements

 

1. When to verify

 

For parental deeming of income development, see SI 01310.207B.1., which contains instructions on when to verify Medicaid eligibility under a state home care plan.

 

2. What to verify

 

Verify that the child is covered by a Medicaid state home care plan under either section 1915(c) or section 1902(e)(3) of the Social Security Act and the date coverage began. Also, verify whether there have been any changes in eligibility under the State home care plan during the review period, or whether any changes are expected in the near future.

 

3. How to verify

 

To verify Medicaid eligibility under either 1915(c) or 1902(e)(3), obtain from the individual/parent a copy of the Medicaid provider agreement form that was completed by the state agency or the institution. This document provides information on the financial arrangements, and it specifies which State agency is authorizing the Medicaid coverage.

D. Verification Procedures

 

1. More than one contact may be necessary

 

For several states, more than one contact is listed. This is because they are each responsible for verifying different groups of eligibles under the state's Medicaid home care plan. This means that more than one contact may be necessary to verify (in)eligibility. If one source cannot verify eligibility under a Medicaid state home care plan, the other must be contacted.

 

2. Use of telephone to verify

 

With the exception of Illinois, Indiana and Minnesota, who have specifically requested that SSA submit written requests for verification, telephone verification is preferred in all cases.

 

Addresses have been provided to better identify the state component providing verification and for use if telephone verification is not feasible.

 

If written verification is requested, include all of the following information in your request:

 

  • the child's name;

  • the child's' SSN;

  • the child's DOB;

  • the parents' names; and

  • address.

 

E. State Contacts

 

1. Illinois

 

a. 1915(c) only.

 

The state has requested that verification requests be in writing. The phone number is not for routine use. Follow-ups may be made by phone if a response to the written request has not been received within 10 working days.

 

Katherine Brennan

Bureau of Policy Development

Illinois Department of Human Services

100 S. Grand Avenue East

Springfield, IL 62762

 

Phone: (217) 782-1239

Fax: (217) 557-5850

 

Requests for verification may be faxed.

 

b. 1902(e)(3)

 

The state does not have this state plan option.

 

2. Indiana

 

a. 1915(c) only.

 

The state prefers that verification requests be made via email. Telephone requests are the secondary method for verification requests (e.g., on sensitive cases).

 

Sandy Owens

Indiana Family & Social Services Administration

Division of Disability, Aging and Rehabilitative Services

402 W. Washington Street

P. O. Box 7083, MS-21 IGCS-W454

Indianapolis, IN 46207-7083

 

Email: lsowens@fssa.state.in.us

 

Phone: (317) 232-7017

 

b. 1902(e)(3)

 

The state does not have this state plan option.

3. Michigan

 

a. 1915(c)

 

Debbie Millhouse

Department of Mental Health

Lewis Cass Bldg. - 5th Floor

Lansing, MI 48913

 

Phone: (517) 241-5757

 

b. 1902(e)(3)

 

Kathy Stiffler

Department of Public Health

Children's Special Health Care Services

400 S. Pine

P.O. Box 30479

Lansing, MI 48909-7979

 

Phone: (517) 241-7186

 

4. Minnesota

 

The state has requested that verification requests be in writing.

 

a. 1915(c)

 

Heidi Hamilton

Minnesota Department of Human Services

Disability Service Division

444 Lafayette Rd. N.

St. Paul, MN 55155-3857

 

Phone: (651) 634-2212

 

Fax: (651) 582-1963

 

Email: heidi.hamilton@state.mn.us

 

b. 1902(e)(3)

 

Mickey Ellis

Minnesota Department of Human Services

Disability Service Division

444 Lafayette Rd. N.

St. Paul, MN 55155-3857

 

Phone: (651) 582-1948

 

Email: mickey.ellis@state.mn.us

 

5. Ohio

 

a. 1915(c) only.

 

Eric Draper

Ohio Department of Jobs & Family Services

Bureau of Community and Long Term Care Services

30 East Broad Street, 27th Floor

Columbus, OH 43215-3414

 

Phone: (614) 466-6742

 

b. 1902(e)(3)

 

The state does not have this state plan option.

 

6. Wisconsin

 

1915(c) and 1902(e)(3)

 

Beth Wroblewski

Bureau of Long Term Support

1 W. Wilson Street, Room 418

P. O. Box 7851

Madison, WI 53707-7851

 

Phone: (608) 266-7469

 

Fax: (608) 261-6752


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0501310207CHI
SI CHI01310.207 - Medicaid Eligibility Under a State Home Care Plan (RTN 373 -- 02/2008) - 02/25/2008
Batch run: 10/08/2024
Rev:02/25/2008