As of Wednesday, March 18, HCA’s lobby will be closed. In-person customer services for Apple Health and the PEBB and SEBB Programs will not be available. Learn more.
Supplemental security income (SSI) recipients
Purpose: To explain Apple Health coverage for recipients of Supplemental Security Income (SSI) recipients.
For ACES Information, see ACES Manual SSP Chapter.
- When SSI benefits begin
- SSA does not pay SSI cash benefits the first month of SSI eligibility;
- SSI individuals are CN Apple Health eligible from first of the month using the date of SSI eligibility;
- SSI eligibility date is on the SDX 1 screen or the SDX page on ACES Online;
- Open CN Apple Health using the first of the month listed in the SSI eligibility date field.
Example: Individual gets first SSI cash payment in October 2014. Individual’s date of SSI eligibility is September 2, 2014. Open CN Apple Health effective September 1, 2014.
- Medical eligibility for ineligible spouse
- The ineligible spouse cannot get SSI related CN Apple Health;
- Determine MN eligibility for an ineligible spouse applying for medical and meeting SSI related criteria.
Medical redetermination when SSI ends:
- Continue CN coverage until eligibility for other health care programs has been determined WAC 182-504-0125.
- Refer the individual to Disability Determination Services (DDS) only when SSI ends due to not meeting the federal disability criteria and:
- There is evidence that the individual’s condition has changed; or
- There is a new disability; and
- Review eligibility for another health care program.
- When SSI ends due solely due to excess income;
- Make a referral to DDS for the end date of their disability approval; and
- Do not delay approval for SSI-related coverage while waiting for DDS disability end date; and
- Make appropriate changes to the DEM 2 when DDS provides the information.
Note: Process and finalize applications (including redeterminations) in the same manner as for other programs except with SSI income.
See Interface – SDX
See SSP – SSI