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Medicaid: How To Maximize Use

If You Receive Medicaid Because You Qualify For Supplemental Security Income (SSI), You Don't Have To Lose Medicaid Even If You Lose SSI Because Of An Increase in SSDI Due To Inflation

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"Pickle Eligibility" is an unusual name for another common reason people lose eligibility. This occurs when people get their Medicaid through Supplemental Security Income ("SSI") and SSI supplements Social Security Disability Insurance ("SSDI") benefits.. Each January, Social Security increases the SSDI benefit by the Cost of Living Increase. The increase can reach the point where the recipient loses eligibility for SSI.

For example, Tom B. receives $482 per month from SSDI. Because that is below the SSI benefit of $500 in the state in which he resides, SSI will pay Tom $18 plus grant him Medicaid. If the annual Cost of Living increase pushes the SSDI benefit to $508 per month, Tom doesn't lose any money, but because his SSDI is now above the SSI limit.

Tom could lose his right to SSI and Medicaid, but doesn't because of the so-called "Pickle Amendment" (named after Representative Pickle). The law provides that someone who stands to lose Medicaid solely because income from SSDI is increased to keep pace with inflation, is permitted to keep Medicaid coverage even though SSI eligibility will be lost.

Pickle Eligibility doesn't always happen automatically. If the increase for inflation that takes effect each January 1 pushes you out of SSI, watch your mail in case you fell through the cracks. If you receive a notice that Medicaid is being terminated due to loss of SSI eligibility, your state Medicaid office is supposed to provide you with an application to move your Medicaid under the Pickle eligibility so you can continue to receive Medicaid .

If you receive an application with notice that you lost your SSI because of the Cost of Living Increase of your SSD contact your Medicaid office immediately and tell them that under the "Pickle Amendment" you should be allowed to continue your Medicaid under "1619B." The Medicaid worker will provide you with the paperwork, if any, which is necessary to continue your Medicaid coverage.

If you want to try to calculate whether the Pickle Amendment applies to you on your own, see:,searchrows~~3,fa~~search,x~~38,searchkeys~~,ia~~0,fromfa~~,searchstart~~1,oq~~,po~~0,ts~~,q~~pickle%2520amendment,y~~4,ct~~0,maxrows~~5,dr~~0&fromFa=search

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