State of Wisconsin Department of Health Services

Release 24-03 December 18, 2024

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25.3 503 Group

25.3.1 Introduction

This group, named after section 503 of Public Law 94-566 extends Medicaid eligibility to certain former SSI recipients if they would be otherwise eligible for SSI benefits if all historical COLA increases to their Social Security benefits since SSI was lost were disregarded.

25.3.2 Identifying a 503 Group

Someone qualifies as a 503 group for Medicaid purposes if they meet the following criteria:

1. They currently receive some type of Social Security benefits.
2. They were previously eligible for SSI (or they were a 1619 participant) but became ineligible for SSI/1619 for any reason.
3. In any month since April 1977, they were eligible for SSI/1619 benefits concurrently with Social Security benefits.

“Concurrently” includes situations in which Social Security benefits are granted retroactively for months in which the person was also receiving SSI. It also includes situations in which SSA recovered the SSI payment because the Social Security payment covers the same period for which the person received SSI. However, "concurrently" does not include situations in which SSI eligibility is granted retroactively for a period in which the person was also receiving Social Security benefits. To be considered a 503 group, a person must have received SSI income in the month prior to the month in which they began to receive the Social Security payment. Sometimes SSI and Social Security payments will be received in the same month, but not always.

Example

Kathy received both SSI and Social Security Surviving Spouse (SSSS) payments for the past five years. She lost her SSI payment due to an increase in unearned income when she began receiving a pension in January of this year. While a COLA increase was not the reason she lost SSI, because the SSI and SSSS payments were received concurrently and then she lost SSI, when her Medicaid eligibility is determined, Kathy is entitled to a disregard of all COLA increases to her SSSS payments since the date SSI was lost.

25.3.3 Determining the COLA Disregard for 503 Group

To calculate the COLA disregard for 503 groups:

1. Find the gross Social Security income, which is the sum of the following:
   1. Net amount of the Social Security payment
   2. Any amount being deducted for Medicare premiums
   3. Any amount being withheld for other reasons (i.e., overpayments, garnishments) 
2. In the “Month SSI Last Received” column in the table below, find the month in which the person was last eligible for and received an SSI payment.
3. Find the decimal figure that applies to that month and the year the Social Security check was received.
4. Multiply the gross Social Security income by the applicable decimal figure and round to the nearest whole dollar.

Note	Once the disregard amount is determined and applied, going forward, all subsequent COLA increases will be disregarded automatically as part of the annual COLA mass change.

 

Month SSI Was Last Received	Multiply 2025 Social Security by:	Multiply 2024 Social Security by:
Jan 2024 - Dec 2024	0.024390	--
Jan 2023 - Dec 2023	0.054642	0.031008
Jan 2022 - Dec 2022	0.130305	0.108563
Jan 2021 - Dec 2021	0.178758	0.158227
Jan 2020 - Dec 2020	0.189298	0.169030
Jan 2019 - Dec 2019	0.202065	0.182116
Jan 2018 - Dec 2018	0.223798	0.204393
Jan 2017 - Dec 2017	0.239018	0.219993
Jan 2016 - Dec 2016	0.241294	0.222326
Jan 2015 - Dec 2015	0.241294	0.222326
Jan 2014 - Dec 2014	0.253976	0.235326
Jan 2013 - Dec 2013	0.265001	0.246626
Jan 2012 - Dec 2012	0.277287	0.259220
Jan 2011 - Dec 2011	0.302401	0.284961
Jan 2010 - Dec 2010	0.302401	0.284961
Jan 2009 - Dec 2009	0.302401	0.284961
Jan 2008 - Dec 2008	0.340644	0.324160
Jan 2007 - Dec 2007	0.355468	0.339355
Jan 2006 - Dec 2006	0.376058	0.360459
Jan 2005 - Dec 2005	0.400632	0.385648
Jan 2004 - Dec 2004	0.416390	0.401799
Jan 2003 - Dec 2003	0.428393	0.414103
Jan 2002 - Dec 2002	0.436285	0.422192
Jan 2001 - Dec 2001	0.450570	0.436835
Jan 2000 - Dec 2000	0.469150	0.455879
Jan 1999 - Dec 1999	0.481592	0.468632
Jan 1998 - Dec 1998	0.488245	0.475451
Jan 1997 - Dec 1997	0.498771	0.486240
Jan 1996 - Dec 1996	0.512897	0.500719
Jan 1995 - Dec 1995	0.525240	0.513371
Jan 1994 - Dec 1994	0.538172	0.526626
Jan 1993 - Dec 1993	0.549875	0.538622
Jan 1992 - Dec 1992	0.562985	0.552060
Jan 1991 - Dec 1991	0.578578	0.568042
Jan 1990 - Dec 1990	0.600169	0.590173
Jan 1989 - Dec 1989	0.618117	0.608570
Jan 1998 - Dec 1988	0.632805	0.623625
Jan 1987 - Dec 1987	0.647606	0.638796
Jan 1986 - Dec 1986	0.652128	0.643431
Jan 1985 - Dec 1985	0.662588	0.654152
Jan 1984 - Dec 1984	0.673998	0.665848
Jul 1983 - Dec 1983	0.685022	0.677148
Jul 1982 - Jun 1983	0.706724	0.699393
Jul 1981 - Jun 1982	0.736263	0.729670
Jul 1980 - Jun 1981	0.769259	0.763490
Jul 1979 - Jun 1980	0.790045	0.784796
Jul 1978 - Jun 1979	0.802859	0.797930
Apr 1977 - Jun 1978	0.813842	0.809188

 

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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