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SD Medicaid for Recipients of SSI and Related Programs

Individuals who receive Supplemental Security Income (SSI) and/or the SD SSI State Supplement are automatically entitled to Medicaid.

Also eligible for full Medicaid medical assistance are:

·      People who Would Otherwise Receive SSI if not for Social Security Cost of Living Increases: Individuals who received SSI after April, 1977 but lost SSI eligibility because of Social Security Disability Insurance (SSDI) cost of living increases are eligible for Medicaid if they would otherwise be eligible for SSI. That is, they meet the disability definition and resource limits, and would meet the income limit if the cost of living increases were disregarded.

·      Disabled People over age 18 who Continue to Receive Social Security Benefits from their Parents: Individuals who receive SSDI as Disabled Adult Children (DAC), and who lost their SSI eligibility after July 1, 1987, because of the SSDI payments or an increase in the payments, are eligible for Medicaid if they would be eligible for SSI with the SSDI amount disregarded.

·      Early Widows or Widowers: Individuals aged 60 thru 64 who receive Title II Early Widow(er)s Benefits, and whose benefit payments cause them to become ineligible for SSI are eligible for full Medicaid coverage unless they are eligible for Medicare Part A.

·      Disabled Widows or Widowers: Individuals aged 50 thru 59 who receive Title II Disabled Widow(er)s Benefits, and whose benefit payments cause them to become ineligible for SSI are eligible for full Medicaid coverage unless they are eligible for Medicare Part A.

Eligibility for Medicare Recipients

Medicare recipients with low incomes and limited resources - but who do not receive SSI or qualify for one of the above programs - are eligible for one of the programs that offer limited Medicaid medical assistance (in which Medicaid pays Medicare co-payments and deductibles and/or Medicare premiums).

These programs are the Qualified Medicare Beneficiary (QMB), Special Low-income Medicare Beneficiary (SLMB), Qualified Individual-1 (QI-1), and Qualified Working Individual (QWI) medical assistance programs. (For more information see: Medicaid for Low-Income Medicare Beneficiaries.)

Sources:

http://www.state.sd.us/social/MedElig/SSI/index.htm and http://www.state.sd.us/social/MedElig/Medicare/index.htm

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Office of Medical Eligibility - Overview

South Dakota Department of Social Services (DSS)

Welcome and Introduction to the South Dakota Benefits Information System

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