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.

In the Boston Region, the section 1634 States are Maine, Massachusetts, Rhode Island, and Vermont.

Copy any trust information provided. Use the “Medicaid Referral to State Agency - Fax Cover Sheet” linked below to fax the information to the State agencies using the contact information in the chart below. Fax is the preferred method of transmittal. You may mail the trust document if the fax option is unavailable.

Medicaid Referral to State Agency - Fax Cover Sheet:

Medicaid Trusts, SI 01730.048