People who are eligible for medical assistance because of the Pickle Amendment are sometimes called "Pickle People". Most of these people used to receive both SSA (Social Security) and SSI, but they are now ineligible for SSI because their income exceeds the SSI limit. Usually, the SSA income has increased beyond the SSI payment level because of cost-of-living adjustments (COLA).
The following rules must be satisfied:
- Individual is currently receiving Social Security Benefits AND
- Individual was eligible for and received SSI in at least one month after April 1977 AND
- Individual was entitled to Social Security Benefits concurrently with the SSI benefits in at least one month after April 1977 AND
- Individual lost eligibility for SSI after April 1977 because their unearned income exceeds the SSI limit AND
- Individual is aged 65 or older or currently blind or disabled as determined by the Social Security Administration or the Disability Determination Office AND
- Individual satisfies the Resource Test for Pickle People (See Resource Rules in Section 4 of this chapter) AND
- Individual satisfies the Income Test for Pickle People (See Income Rules in Section 5 of this chapter)
Pickle Financial Unit
The financial unit rules defines whose income and resources are considered in the financial eligibility determination.
In the Pickle People category the financial unit will consist of one of the following:
- Eligible Individual with no Spouse
- The aged blind or disabled person AND
- If the individual is an alien, the income of the alien's sponsor and the sponsor's spouse if the spouse lives with the sponsor is included.
- SSI Recipients are not included
- Eligible Child
- The aged blind or disabled child AND
- The parent(s) if the child is living with parent(s) AND
- If the child is an alien, the income of the child's sponsor and the sponsor's spouse if the spouse lives with the sponsor is included.
- SSI recipients are not included
- Eligible Couple
- The aged blind or disabled individual AND
- If the individual is an alien, the income of the alien's sponsor and the sponsor's spouse if the spouse lives with the sponsor is included AND
- The spouse who is living in the home AND
- The spouse is also potentially eligible for Medical Assistance under the Aged, Blind and Disabled category AND
- If the spouse is an alien, the income of the alien's sponsor and the sponsor's spouse if the spouse lives with the sponsor is included.
- SSI recipients are not included
- Eligible Individual With Ineligible Spouse
- The aged blind or disabled person AND
- If the individual is an alien, the income of the alien's sponsor and the sponsor's spouse if the spouse lives with the sponsor is included AND
- The spouse who is living in the home AND
- The spouse is not eligible for Medical Assistance under the Aged, Blind and Disabled category.
- SSI recipients are not included
Resource Household Size for Pickle People
The household size consists of the same individuals as listed in the financial unit for Pickle People above with the following exceptions:
- Do not include the alien's sponsor and the sponsor's in-home spouse in the household size OR
- Do not include a parent(s) living in the home in the household size OR
- Do not include SSI recipients in the household size
Income Household Size for Pickle People
The household size consists of the same individuals as listed in the financial unit for Pickle People above with the following exceptions:
- Do not include the alien's sponsor and the sponsor's in-home spouse in the household size OR
- Do not include a parent(s) living in the home in the household size OR
- Do not include SSI recipients in the household size OR
- Do not include the ineligible spouse in the household size when there is no deemable income