Appalachian Trail

Hi Ben!

I had a question recently about State-Only 1619(b) and assets. In getting the answer I was told State-Only 1619(b) works “just like federal 1619(b)” yet I am unclear exactly how that works as well. So, my question is this: If a person is receiving Medicaid under 1619(b) and goes over $2,000 in assets one month but then is back under $2,000 three months later can that person go back onto 1619(b)?

Thanks for all your help, Ben! Enjoy whatever destination you find yourself in next! Terri

Terri,

The short answer to your question is: yes, the person in the situation you described would regain 1619(b) status.

The reason has to do with the distinction between “suspension” of SSI and “stop payment” of SSI.

Suspension occurs when a person becomes ineligible for SSI; for example, having excess resources at the beginning of a calendar month. Generally an SSI recipient has twelve (12) consecutive months after the effective date of suspension to be reinstated (without a new application) if eligible again.

More from the Appalachian Trail!

Stop payment status is an interruption in SSI payments and not the loss of eligibility; 1619(b), not receiving payments due to work earnings, is a stop pay situation so eligibility continues. Cash payments may be reinstated on a stop pay record regardless of how long the recipient has been in non-pay.

If a recipient becomes ineligible during a stop pay period (such as in your case), the payments are suspended and the principle stated above applies: the recipient has 12 consecutive months to be reinstated to pay status or stop pay status (1619b) if eligible again. Of course, to regain 1619(b) eligibility, the person would also need to meet the other 1619(b) requirements. (POMS SI02301.201)

To put it another way, an SSI recipient who does not meet a nondisability requirement in a month (other than excess income due to work) goes into suspense status and stays there until the first month within the next 12 in which all requirements are met for 1619(b) or regular payments. (POMS SI 02302.010E.1)

I’m responding to you from Max Patch (near Hot Springs, NC); I am hiking on the Appalachian Trail where the mountains are high and smoky. I was playing a little mandolin (see Mom I do practice!) and these two fellow hikers stopped to listen for a while!

Ben