24.1 SSI Related Medicaid Introduction

SSISupplemental Security Income. A program based on financial need operated by the Social Security Administration that provides monthly income to low income people who are age 65 or older, blind, or disabled.-related Medicaid is the basic Medicaid program for individuals who are elderlyAnyone 65 years old or older, blind, or disabled and who are not receiving SSI. SSI-related individuals must meet Medicaid nonfinancial eligibility requirements (see Section 4.1 Who is Nonfinancially Eligible for Medicaid?). SSI-related Medicaid has the lowest income and asset limits of all EBD Medicaid programs/categories. It has two income limits which are referred to as the "categorically needy" limit and the "medically needy" limit (see Section 39.4.1 ELDERLY, BLIND, OR DISABLED ASSETS AND INCOME TABLES for the SSI-related categorically needy and medically needy income limits).

Categorically Needy
A fiscal test group with countable net income that does not exceed the categorically needy income limit passes the SSI-related Medicaid categorically needy income test.

Medically Needy
If a fiscal test group’s countable net income exceeds the categorically needy income limit, their income is then compared to the medically needy limit of 100% FPL. If the fiscal group’s countable net income is between the categorically needy limit and the medically needy limit, the group passes the Medicaid SSI-related medically needy income test.

Deductible
If a fiscal group’s countable net income exceeds the medically needy income limit, they can still qualify for Medicaid by meeting a deductible, if otherwise eligible (see Section 24.2 Medicaid Deductible Introduction and Section 24.5 Calculating the Deductible).

This page last updated in Release Number: 22-01
Release Date: 04/04/2022
Effective Date: 04/04/2022

The information concerning the Medicaid program provided in this handbook release is published in accordance with: Titles XI and XIX of the Social Security Act; Parts 430 through 481 of Title 42 of the Code of Federal Regulations; Chapters 46 and 49 of the Wisconsin Statutes; and Chapters HA 3, DHS 2, 10 and 101 through 109 of the Wisconsin Administrative Code.

Notice: The content within this manual is the sole responsibility of the State of Wisconsin's Department of Health Services (DHS). This site will link to sites outside of DHS where appropriate. DHS is in no way responsible for the content of sites outside of DHS.

Publication Number: P-10030