Medical Assistance (MA) Chapter 400 AHCCCS Medical Assistance Programs >> 413 Supplemental Security Income Medical Assistance Only (SSI MAO)
  
413 Supplemental Security Income Medical Assistance Only (SSI MAO)
 
Policy
Definitions
Service Package
Enrollment
Customer Costs
Programs and Legal Authorities
 
Policy
 
The conditions of eligibility for the Supplemental Security Income Medical Assistance Only (SSI MAO) program are:
Valid application (MA533);
Categorical element:
Aged (MA501);
Blind (MA504); or
Disabled (MA509);
Resident of Arizona (MA531);
Social Security number (MA532);
US citizen (MA507) or appropriate non-citizen status (MA524);
Not incarcerated (MA525);
Apply for potential benefits (MA526);
Assignment of rights to medical benefits and cooperation (MA503); and
Income at or below 100% of the FBR or 100% of the FPL (MA615.2).
NOTE In addition to the general conditions of eligibility listed above, a customer may be eligible for SSI MAO under one of the following categories:
Disabled Adult Child (DAC);
Disabled Child (DC);
Disabled Widow/Widower (DWW); or
Pickle.
 
Definitions
 
Term
Definition
Supplemental Security Income Medical Assistance Only (SSI MAO) Program
The SSI MAO program is for customers who:
Are aged, blind or disabled; and
Do not receive SSI cash.
Disabled Child (DC) Coverage Group
For customers who:
Meet general conditions of eligibility for SSI MAO;
Are under age 18 (MA501);
Received SSI Cash as a child before August 22, 1996 (MA529);
Continue to meet disability requirements established as of August 22, 1996 (MA509); and
Have countable income less than or equal to 100% of the FBR.
Disabled Adult Child (DAC) Coverage Group
For customers who:
Meet general conditions of eligibility for SSI MAO;
Are over age 18 (MA501);
Received SSI Cash in the past (MA529);
Became ineligible for SSI cash on or after July 1, 1987, due to entitlement to or an increase in Title II (SSA) payments as a disabled adult child (MA529);
The WTPY shows a “C” claim number that is either credited or not credited; and
Has countable income less than or equal to 100% of the FBR.
Disabled Widow/Widower (DWW) Coverage Group
For customers who:
Meet general conditions of eligibility for SSI MAO;
Are age 50 or older but not yet 65 (MA501);
Not entitled to Medicare Part A (MA521);
Not currently married;
Received prior SSI Cash disability payment (MA529);
Has a Medicare Claim number with a “D” or “W” BIC code; and
Has countable income less than or equal to 100% of the FBR.
Pickle Coverage Group
For customers who:
Are receiving Social Security Title II (MA530);
Received prior SSI Cash payment (MA529);
Received both SSI Cash and Title II payments in the same month for at least one month; and
Have countable income less than or equal to 100% FBR.
 
 
Service Package
 
Customers who meet all requirements for the SSI MAO program receive full AHCCCS Medical Assistance coverage.
Customers who meet all requirements except U.S. citizenship or qualified non-citizen status receive emergency services only.
For a description of the AHCCCS Medical Assistance service packages, see MA302.
Enrollment
 
Customers approved for coverage under the SSI MAO program are enrolled in an AHCCCS Health Plan (Chapter 1100).
Emergency Services are paid for by AHCCCS on a fee-for-service basis.
 
Customer Costs
 
Customers do not pay a premium for coverage under the SSI MAO program. However, the customer may have co-payments for certain services (MA1205).
 
Programs and Legal Authorities
 
This requirement applies to the following programs:
Program
Legal Authorities
SSI MAO
Title 42, Chapter 7, Subchapter XIX of the USC
Title 42, Chapter IV, Part 435 of the CFR
Title 36, Chapter 29, Article 1 of the ARS
Title 9, Chapter 22, Article 15 of the AAC
Disabled Adult Child (DAC)
Disabled Widow/Widower (DWW)
Title 42, Section 1383c of the USC
Title 42, Chapter IV, Part 435.210 of the CFR
Title 36, Chapter 29, Article 1 of the ARS
Title 9, Chapter 22, Article 1505 of the AAC
Disabled Child (DC)
Title 42 1396a(a)(10)(A)(i)(II) of the USC
Pickle
Title 42, Section 1383c of the USC
Title 42, Chapter IV, Part 435.135 of the CFR
Title 36, Chapter 29, Article 1 of the ARS
Title 9, Chapter 22, Article 1505 of the AAC