Supplemental Payments Manual – Table of Contents

0710.000.00 SSI-ONLY CASES

Individuals who received a cash OAA, PTD, or AB grant in December 1973 and whose earned and unearned income was less than the SSI maximum, were eligible for the maximum SSI payment. Since the state was not required to supplement the SSI payment, these individuals are not considered “conversion” cases for the purposes of the state’s obligation to supplement.

The Department of Health and Human Services, Health Care Financing Administration (HCFA), determined that the state did not have an option to “grandfather in”, for Medicaid, those cases receiving OAA, PTD, OR AB and who were not eligible to receive a cash supplement when the SSI program took effect in January 1974. This is the group of cases we have previously specified as “SSI-Only” cases. The federal interpretation is that automatic Medicaid could only be granted to those individuals who were eligible to receive a cash state supplement (i.e., SSI-SP and SP-Only cases). Those individuals who were converted and were eligible for only an SSI payment must qualify for Medicaid under the state’s Medical Assistance (MA) program.

NOTE: Due to this change, the “SSI-Only” case is no longer considered a valid conversion category. Thus, these individuals no longer have any conversion rights and they cannot gain a conversion status of SSI-SP or SP-Only. Only those individuals who were converted and continue to receive a CASH supplement are eligible for conversion rights, under the law.

The following action is REQUIRED on “SSI-Only” cases.

  1. Conduct reinvestigations on an annual basis.
  2. Treat cases that are closed and subsequently reapply, as any other MA application. Obtain an Application for Benefits. If the claimant is found to be eligible for MA, open the case under a “M” number.