For Medicaid eligibility, we count income for ABD-related benefits consistent with SSI’s methodology. This ensures that SSI recipients are deemed eligible for Medicaid without requiring additional income or resource verification. (An SSI recipient should never be required to provide verification of income or resources.)

On the SDX screen in IMS the following blocks are:

Block 16 Earned Income is the countable earned income after SSI applied all their deductions. Use this as the countable earned income in FACS. You won’t apply any deductions to this amount.

Block 17 Deemed Income is the amount SSI counted from a parent for a minor child or from a spouse for an adult.

For a minor child, enter the amount from Block 17 into “Other” income using the indicator “Income Received from Other HH Member”.

For adults, this is the portion of the spouse’s income that was counted by SSI after deductions. This will be entered in the Income tab under the spouse. The spouse should be coded “income/resources considered, not included in benefit”.

Block 8 Net Unearned Income block shows the countable unearned income after deductions have been applied ($20 GIE). The difference between the total unearned income from Block 9 of the SDX and the amount in Block 8 is to be coded in the Diverted Income block.

Block 9 Specific sources of unearned income are listed in the bottom of the SDX such as Soc. Sec, Child Support, VA, and pensions, etc.  Lines with no end date are what SSI identified as what the person is currently receiving and must be verified. Upon verification, these sources are to be coded in FACS accordingly.

***Report to SSI if the client has any income not being counted toward the SSI benefit per the SDX screen. The income not being counted toward the SSI benefit is either diverted or not entered into FACS. Update the case notes.

When you have ABD and SNAP for an SSI recipient on the same case, please reference the following article to know how to code the income so that it counts correctly for each benefit: How to Code SSI Income to Count Correctly for SNAP and SSP | Quest

Example 1

Terry reports he receives SSI, RSDI, and works about 10 hours a week at Taco Indio.

His SDX screen looks like this:

Income to be coded in FACS

Earned income: $18 ($17.50 rounded up)

SSI: $726 ($725.50 rounded up)

RSDI: $244

Diverted income $20 [$244 (RSDI) – $224 (Net Unearned)]

Example 2

Jean is on SSI and married to Tim. Tim works so SSI is deeming income from him to her. Her SDX screen looks like this:

Income to be coded in FACS

Jean SSI: $883 ($882.50 rounded up)

Tim Countable Earned: $568 (rounded up from $567.50)

Wage Indicator: Above Minimum Wage

Example 3

José Flores is applying for ABD-related benefits. He has been receiving $967 in SSI. He started receiving a Disabled Adult Child (DAC) benefit $749 from his mother, which SSI hasn’t adjusted yet. (Block 09 Net Unearned Income shows $749) Although the DAC payment is showing in Block 09 and SSI has not made an update to the benefit, divert the Soc Security DAC payment in FACS.

Income coded in FACS:

SSI: $967

Example 4

Jonathan Harris is a child on SSI. His SDX looks like this:

Income coded in FACS:

SSI: $26 (rounded up from $25.50)

Other: $942 (rounded up from $941.50)-Income Received From Other HH Member