How to Round SSI and RSDI for Medical

Guidelines on rounding SSI and RSDI income for Medical Eligibility Determination

Social Security Early Retirement and Categorical Relationship

Impact of Early Retirement on Eligibility

Applications – ABD Related & SSA Appeal

Information regarding previously denied applications and when they can be used again to certify a medical benefit.

Resolving a Social Security Income SDX/BEN Discrepancy

This discrepancy is considered verified upon receipt. This means that once the discrepancy is received, the worker checks the appropriate screens (SDX or BEN) to see if the client is receiving new income from the Social Security Administration or if the previous income has changed or ended. The worker updates the case based on this […]

Buy-In – What is Buy-In?

What is Buy-In? “Buy-in” is the procedure whereby the Oklahoma Health Care Authority (OHCA) pays the client’s Medicare premium through the Centers for Medicare & Medicaid Services (CMS). DHS determines eligibility and oversees operation of Buy-in Program CMS oversees Medicare program Social Security Administration (SSA) enrolls people in Medicare The Buy-in programs are QMB, SLMB […]

Buy-In – Medicare Buy-in Problems and Solutions

If there are any issues with the Buy-In, look over the following items to verify that they are correct on the case: Certification period 12 months Claim number on Bendex (Block B07) Medicare cards are now issued with a new Medicare number that is unique to the beneficiary instead of using SSN-based Health Insurance Claim […]

BENDEX State Codes

State/Agency Part A (HI) Code Part B (SMI) Code Alabama S01 010 Alaska S02 020 Arizona S03 030 Arkansas S04 040 California S05 050 Colorado S06 060 Connecticut S07 070 Delaware, Public Assistance S08 080 District of Columbia S09 090 Florida S10 100 Georgia S11 110 Guam N/A 650 Hawaii S12 120 Idaho S13 130 […]

BENDEX Income Codes

The following BENDEX Income codes provide additional details regarding income. B21 Date Initial Entitlement B22 Current Entitlement Date B23 Entitlement Effective Date B24 Retro Payment Amount B25 Direct Deposit Indicator B26 – Payment Cycle Indicator Indicates when the benefit check was released 3RD = 3rd of the month 2WED = 2nd Wednesday 3WED = 3rd […]

BENDEX Payment Status Codes

Block B20 refers to the Payment Status Code – Displays the SSA payment status for the beneficiary. The Codes are broken down in the following categories. Adjustment Abatement Current Pay Deferred Denied Delayed Suspended Terminated Uninsured Withdrawal Other Adjustment AA Withdrawal To Split Payments AC Correction In Benefit Rate AD Adjusted For Dual Entitlement AE […]

Benefits Data Exchange Inquiry (BENDEX) Codes

BEN is the online BENDEX Benefits Inquiry. To view this screen: Login to IMS Clear the screen Type BEN (space) and the social security number Press ‘Enter’ You can also access the screen by typing the following in IMS: ‘BEN (Space) and the Claim Account Number’ BENDEX Codes 1-14 provide identifying information regarding the Beneficiary […]