The Finance and Medical sections will need to be closed with the appropriate code such as earned income exceeds agency standards; RSDI income exceeds agency standards, etc. The case will be certified for Special Medical. You will not need a new application or get any new documentation from the client for this certification.

Example:
Reba Parton has been receiving SSI and the SSP for the last two months. This month she started to receive $1100 from Social Security as a dependent benefit. Since this will lose eligibility for the SSP because of the dependent benefit, she will be eligible for Special Medical as a DAC (Disabled Adult Child). The $1100 RSDI was added to Reba’s case and both the Finance and Medical sections were first closed for RSDI income, since RSDI is the income that put her over the SSP standard.

• On the Financial Assistance tab in Eligibility Notebook:
  • Section B-Fin Assistance: Type Action Taken: CLOSED (6)
  • Reason: RSDI INCOME EXCEEDS AGENCY STANDARDS (10)

  

• After processing closure, refresh the case, before certifying for Special Medical.
  
• On the Household tab in Interview Notebook:
  • Medical Assistance –Title XIX – ADDED TO BENEFIT
  • Disabled – State Supplement for the Disabled – SPECIAL MEDICAL

  

• On the Income tab in Interview Notebook:
  • Make sure that all income information is correct and code appropriately.

  

• On the Financial Assistance tab in Eligibility Notebook:
  • Section B-Fin Assistance – Type Action Taken: – SPECIAL MEDICAL BENEFITS CERT-ABD ONLY (M)
  • Reason: ELIGIBILITY ESTABLISHED WITHIN TIME LIMITS
  • Certification Date – Enter the date the SSP was closed.
  • Effective Number of Months: 99)BENEFITS WILL BE ISSUED USING THIS INFORMATION INDEFINITELY Note: If you receive an edit PSEBX149 (If B6 is keyed – then B3, Action Taken must be 1, 5, R, or C), you may have to “reset” the block to clear the edit.
  • Date Last Redetermination – Enter the date the SSP was closed.

  

  **SAVE the CASE and PUSH CASE completely through**