SSI and Medicaid for Children
Authored By: FloridaLawHelp.org
How do children on SSI qualify for Medicaid? +
Children who receive SSI benefits are automatically eligible for Medicaid.
What happens if a family receives a notice that their child’s SSI benefits will stop? +
If a family receives a notice that their child’s SSI benefits will stop, the state must continue Medicaid eligibility for at least 50 days to give the family time to appeal the decision. If the family files an appeal and requests continued SSI benefits, the child will be eligible for Medicaid through the SSI appeals process. A request must be filed with the Social Security Administration within 60 days to appeal the end of SSI benefits. But to continue receiving benefits during the appeal, you must file within 10 days.
What happens if DCF decides the child is not eligible for Medicaid? +
DCF must give 10 days written notice before stopping the child’s Medicaid. This notice must say why Medicaid is being stopped and how to request a fair hearing to appeal the decision. The family has 90 days to appeal the decision.
A Fair Hearing must be requested within ten (10) days for Medicaid coverage to continue through to your Fair Hearing.
How can I request a Medicaid fair hearing? +
To request a fair hearing, you can write or fax:
Office of Appeal Hearings
Dept. of Children & Families
Building 5 – Room 203
1317 Winewood Blvd.
Tallahassee, FL 32399-0700
Phone: (850) 488-1429
Fax: (850) 487-0662
It is a good idea to keep a copy of your written request. If you call, you will want to follow your call with a letter and keep a copy of your letter.
Be sure to ask for "aid-paid-pending the hearing” to make sure that Medicaid continues during the appeal. If you need help with an SSI or Medicaid appeal, you can contact your local legal aid program.