Medicaid and Supplemental Security Income eligibility
When you apply for Social Security Disability or Supplemental Security Income in Pennsylvania, you might also be eligible for Medicaid coverage. Pennsylvania is one of the states that has an agreement known as the 1634 agreement regarding Medicaid eligibility when a person qualifies for federally administered state supplementary payments.
In most cases, if you qualify for SSI payments, you will qualify for Medicaid to help you ensure that you get the medical care you need. Medicaid can help you to get a variety of services, including long-term care, as long as it is considered medically necessary.
It is important to note that the Social Security Administration isn’t the agency that determines if a person is eligible for Medicaid coverage. Instead, the SSA refers the person’s case to the state and then the state makes the determination. Under the 1634 agreement, the state would approve SSI recipients.
In the case of a person who is denied SSI, the SSA would send notice to the state. The state could then send a denial of Medicaid to the applicant.
For people who need SSI and Medicaid to survive and cover basic necessities, denials can be heart-wrenching. Filing an appeal in those cases is possible, but the appeals must be filed exactly as instructed. Any deviations or omissions can result in a denial of the appeal.
If you are applying for SSI or have been denied for benefits, working to understand the system might help you as you try to obtain benefits. This means that you should seek out answers to all your questions.