M1005C Determining Goldberg/Kelly Eligibility
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Purpose: This section will assist in determining whether an individual is eligible for Medicaid benefits under Goldberg/Kelly.
Current Policy Effective Date: September 1, 2010
Date Last Reviewed: March 31, 2010
Previous Policy: October 1, 2009
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POL M1005C: Determining Goldberg/Kelly Eligibility
1. SSA Determines Goldberg/Kelly Eligibility
SDX shows eligibility with a Medicaid eligibility code of “G.”
2. Applicants Potentially Eligible Under Another Medicaid Coverage Group
If the SDX shows a Medicaid test indicator code “S,” determine if the applicant is eligible under another Medicaid coverage group.
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Reference:
Defining Group: 42 CFR 435.120
Clarifying Information:
1. Goldberg/Kelly is defined as a Supreme Court decision requiring a client be given written notice prior to
reduction, suspension or termination of SSI.
2. SSI payments will continue at the previous rate when a timely appeal is filed. These payments will
continue until a decision is made.
3. These individuals are eligible for Medicaid benefits and are authorized through the SDX.
Training Link: Not available at this time.
Worker Responsibilities:
Determining Eligibility When Clients on SDX With Test Indicator Code “S”
1. Require an EC-200 EqualityCare (Medicaid) Application.
2. Determine eligibility under another Medicaid coverage group.
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