TN 4 (04-07)

Citations:

Section 1634(a) of the Social Security Act

Regulations--20 CFR 416.2101-416.2116

A. Introduction

The SSA-8000-BK, Application for Supplemental Security Income, is worded to protect claimants' rights to Medicaid under Title XIX. The scope of the application with respect to medical assistance depends upon the agreements made between SSA and each State. SSI applications are applications for Medicaid under Title XIX of the Act where applicable.

B. Policy

1. SSA Makes Medicaid Determination

The SSI application is also an application for Medicaid when SSA has an agreement to make Medicaid eligibility determinations on behalf of a State. SSA's application date policy applies to this Medicaid application.

2. SSA Does Not Make Medicaid Determination

When SSA does not have an agreement to make determinations for the State, an individual must file an application with the State/local Medicaid agency.

C. Procedure

In states where SSA makes the title XIX determination, inform the applicant that the SSI application is also an application for Medicaid and that there is no need to file another application.

NOTE: If unpaid medical expenses exist for the period prior to the month of the SSI application, the State may require a separate Medicaid application.

D. References

• SI 01715.001- SI 01715.020, Medicaid Program

• SI 01730.005, SSA Determinations of Medicaid Eligibility

• SI 01730.060 , Field Office Procedures

• SI 00601.010D, Scope of Application