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Social Security Benefits COLA (“Pickle Amendment”).

Effective July 1, 1977, Medicaid eligibility was protected for SSI recipients who would be entitled to SSI or State Supplement Payments (SSP) eligibility if Title II cost-of-living adjustments (COLAs) were excluded. Under section 503 of Public Law 94-566, the “Pickle Amendment,” Title II beneficiaries who would continue to receive SSI/SSP payments (or would continue to be eligible for benefits under section 1619(b)) but for their Title II COLAs continue to be considered SSI or SSP recipients for Medicaid purposes. If an individual’s other income would not have precluded continuing SSI payments (or deemed payments under section 1619(b)) without the Title II COLAs, the State must continue to consider the individual to be an SSI recipient for Medicaid purposes.

When a State agency computes Pickle eligibility it uses the current SSI Federal benefit rate (FBR) plus any State supplement payment. The agency compares that amount with the beneficiary’s other countable income plus the part of the Title II benefit that can not be excluded. What can’t be excluded is the amount of Title II benefit the person was receiving when SSI/SSP payment eligibility was lost. Unlike the following two groups of special Medicaid beneficiaries, an individual who may receive Medicaid under the Pickle provision could have lost SSI for other reasons than the cost-of-living-Adjustment. Instead of what the person was receiving at the time of the lost benefit, the issue is whether the person would otherwise be eligible for SSI if the COLA(s) were deducted.

Example of How the Pickle Amendment Applies:

Casey was receiving SSDI in the amount of $564 in 2002. He was not working. Casey’s cost-of-living adjustment raised his benefit to $572 in 2003. In 2002, Casey was due $1.00 in SSI, and was entitled to Medicaid. With the cost-of-living raise, however, Casey’s unearned income is now too high for him to receive any SSI payment. Also, since it was unearned income rather than earnings that eliminated Casey’s cash benefit, he may not access the 1619(b) work incentive. In Casey’s situation, the Medicaid agency must exclude the increase between $564 and $572 that caused Casey to lose his SSI benefit. Since Casey has no other income, he is eligible for continued Medicaid through the state Medicaid agency if he would continue to be eligible for SSI but for the title II COLA (e.g., he is still in the US and is still disabled). If Casey had other income, the amount and type of that income would be material when the State was determining his eligibility for Medicaid.

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FAQ Disclaimer: The VCU-BARC FAQ Pages are general information provided as a public service. The contents do not necessarily represent the policy, interpretations or opinion of the Social Security Administration (SSA). The information contained here is intended to inform readers of issues that may affect Social Security and/or other public assistance benefits. Because individual circumstances differ, the reader should not rely on any information here as being specifically applicable to an individual's situation.