MR #25.36 Children Receiving Supplemental Security Income

Illinois Department of Healthcare and Family Services

10/01/2025

Summary:

Confirms medical program policy and Integrated Eligibility System (IES) functionality for children (under age 19) who receive Supplemental Security Income (SSI).
Notes miscellaneous update for revision of PM 19-04-01: Restoring Assistance Due to Error, Appeal, or Spenddown Not Met and WAG 19-04-01: Restoring Assistance Due to Error, Appeal, or Spenddown Not Met sections.

This manual release provides guidance and clarification related to medical program eligibility determinations for children (under age 19) receiving SSI benefits.

Medical Program Eligibility Determination

Children (under age 19) currently receiving SSI are not eligible for Medicaid Expansion eligibility groups formerly identified as All Kids Share, All Kids Premium 1, and All Kids Premium 2; these children are eligible for Aid to the Aged, Blind and Disabled (AABD) Medical.

Reminder: Household income and resources are exempt for children determined eligible for SSI and who currently receive SSI. Receipt of SSI is acceptable verification of financial eligibility for both income and resources, per PM 02-07-03-i: Resources. SSI recipients must meet non-financial eligibility requirements.

IES Functionality

MANG P code 6S and AABD Medical TOA are assigned for children receiving SSI. The MANG P code 6S description is Child < 19 receiving SSI. When a child is approved for the AABD Medical TOA a notice reason is assigned at the individual level stating Eligible child due to receiving SSI.

Income and resource tests are not applied, as household income and resources are not budgeted for children receiving SSI. Income and resource information entered in Data Collection is recorded but not included in the child's AABD Medical EDG. The Income and Resource Tabs will be disabled in the EDG Summary.

If the Social Security Administration (SSA) determines the child is no longer eligible to receive SSI, and the child has been certified for AABD Medical, the child will continue to receive AABD Medical for the remainder of the certification period due to continuous eligibility.

If a child transitions between a MAGI TOA and AABD Medical TOA, a 360C Notice of Decision will be generated and sent to the household.