Clients who have SSI applications pending are not eligible for cash assistance from our Department. Clients with SSI applications pending who are found disabled by CAU may qualify for P3 assistance under the AABD program. A P3 client receives the same medical coverage as a Category 93 client. To be eligible for P3 or 93, a client must be found disabled by CAU. In determining eligibility, the same medical assistance standards are used. The only differences are:
- a P3 client has an SSI application pending; or
- has appealed a finding of "not disabled" at the reconsideration level or the Administrative Law Judge (ALJ) level; and
- a P3 client cannot be set up as a spenddown case.
It is important to authorize medical assistance as Category P3 for clients who have an SSI application pending and whose countable income is below the income standard. The P3 case will be matched monthly with SDX information. When SSA denies a client's SSI application, and the client does not appeal, the client is no longer eligible for AABD medical assistance (P3 or 93). The authorization of Category P3 assistance allows a central monitoring of the status of the client's SSI application and subsequent medical assistance eligibility.
When it is discovered that a client who has been authorized Category 93 assistance has an SSI application pending (and their countable income is less than the Medical Income Standard) change the category of assistance from 93 to P3.
A person applying for Category P3 is eligible for temporary medical benefits if the Department is responsible for disposition delay. See PM/WAG 17-03-03.