G-4300, Special Income Exclusion for COLA Disregard

Revision 23-1; Effective March 1, 2023

G-4310 Computing Social Security Cost-of-Living Increases

Revision 24-1; Effective March 1, 2024

The following chart shows the Pickle (ME-Pickle) multiplier for Social Security cost-of-living adjustments.

Note: Additional information for prior years is available in Appendix XXXVIII, Pickle Disregard Computation Worksheet.

To calculate the Pickle disregard, use the chart above to determine the appropriate multiplier based on the date the person last received a Supplemental Security Income check. Multiply the current Retirement, Survivors and Disability Insurance benefit amount by the multiplier and round the result to the nearest whole dollar. Subtract this disregard amount and all other available exclusions from the person's available income to determine the person's countable income.

Note: For calculating manual budgets, refer to step 5 in Section G-5100, Individual and Couple Noninstitutional Budgets, or use Appendix XXXVIII, Pickle Disregard Computation Worksheet.

Follow this procedure for any family member whose income is considered in the eligibility determination.

G-4311 Pickle

Revision 13-1; Effective March 1, 2013

For persons who qualify for Pickle (ME-Pickle) and who received a 20% Social Security cost-of-living adjustment (COLA) increase in October 1972, exclude the amount of that increase in determining the person's eligibility.

For persons who qualify for Pickle (ME-Pickle) because of an SSI denial after April 1977, exclude Social Security COLAs received since the person last received both SSI and Social Security benefits in the same month. The person must have been entitled to both benefits in the same month. Because SSA processing procedures can be unpredictable, the person may not actually have received both checks/direct deposits in the same calendar month.

Note: Also exclude Social Security COLAs for the same period from the income of any family member whose income is deemed to the individual. The earliest increase that can be excluded is the July 1977 increase.

When an application for Pickle (ME-Pickle) assistance is received, verify the SSI denial date and current benefit and use the appropriate multiplier to calculate the disregard amount. Do not contact the Social Security office for this information.

Allow the COLA disregard after the date of denial. If the denial was sometime after the normal yearly December/January COLA, then the next available COLA would be available as the disregard.

Example: If denial is in May 2007, the next COLA disregard available to the person would be in January 2008 using Appendix XXXVIII, Pickle Disregard Computation Worksheet.

A variance to this may occur when a decision from SSA is delayed. Address entitlement, date of denial, and date of receipt of notice of denial when dealing with this.

Do not certify the person for Pickle (ME-Pickle) if the income before the COLA disregards is less than the SSI federal benefit rate (FBR). A person whose income, before the COLA exclusion, is less than the SSI FBR cannot be certified for the Social Security COLA programs.

• An SSI person who goes on and off SSI because of Social Security rounding is not eligible for Pickle (ME-Pickle) until he has been denied SSI because of a COLA increase.
• Persons who lose SSI eligibility because of a transfer of assets penalty do not qualify for Pickle (ME-Pickle) while the penalty period is in force. These individuals should be tested for potential eligibility under other MEPD programs, including Qualified Medicare Beneficiary.

Except in certain situations, a person cannot be eligible for the Pickle program.

G-4312 Ping-Pong

Revision 11-4; Effective December 1, 2011

In certain situations, a person whose income is less than the SSI federal benefit rate can be certified for the Social Security COLA programs.

In "ping-pong" cases, when a Pickle (ME-Pickle) person goes on and off SSI with a $1 check, maintain the case as an ongoing Pickle (ME-Pickle). This will stabilize receipt of Medicaid benefits.

G-4320 Special Income Exclusion for Disabled Adult Children

Revision 11-4; Effective December 1, 2011

ME-Disabled Adult Child. Individuals 18 and older who were denied SSI benefits on or after July 1, 1987, because of entitlement to or an increase in RSDI disabled adult children's benefits may be eligible for Medicaid if they otherwise would meet all current SSI eligibility criteria in the absence of those disabled adult children's benefits. Eligible individuals are also entitled to the exclusion of subsequent increase in those benefits.

After receiving an application for ME-Disabled Adult Child assistance, verify the amount of the appropriate disabled adult children's benefit or increase in order to determine the appropriate disabled adult children exclusion. If the person is in a vendor living arrangement, develop the case under the institutional guidelines.

G-4330 Special Income Exclusion for Widow/Widower

Revision 11-4; Effective December 1, 2011

ME-Early Aged Widow(er). Disabled individuals 60 and older who were denied SSI benefits because of entitlement to early aged widow's or widower's benefits may be eligible for Medicaid if they meet all current SSI eligibility criteria in the absence of those early aged widow's or widower's benefits.

Eligible individuals are also entitled to the exclusion of subsequent increases in these benefits. They may continue to receive Medicaid until they are eligible for Medicare. Medicaid benefits under Widow/Widower (ME-Early Aged Widow(er)) cannot begin before July 1, 1988, regardless of when an individual became eligible for or was denied SSI.

ME-Disabled Widow(er). Disabled individuals who were denied SSI benefits because of an increase in widow's or widower's disability benefits as a result of the relaxing of disability criteria may be eligible for Medicaid if they meet all SSI eligibility criteria in the absence of those widow's or widower's disability benefits.

Eligible individuals are also entitled to the exclusion of subsequent increases in these benefits. They may continue to receive Medicaid until they are entitled to Medicare. Medicaid benefits under this coverage group were not available before Jan. 1, 1991, regardless of when an individual became eligible for or was denied SSI.

Note: The widow's or widower's disability benefits under Social Security begin at age 50. ME-Disabled Widow(er).

After receiving an application for Widow/Widower (ME-Early Aged Widow(er), ME-Disabled Widower) assistance, verify the amount of the early aged/disabled widow's or widower's benefit. If the applicant/person is in a institutional living arrangement, develop the case as under the institutional guidelines.