SSI/SSP Medi-Cal Identification Cards

SSI/SSP Initial BIC Issuance

SSI/SSP eligibility is determined by the Social Security Administration (SSA). SSA completes computer entries to transmit cash-linked MC eligibility to MEDS via State Data Exchange (SDX). SDX transactions are sent to MEDS on a weekly basis; MEDS then sends transactions to EDS to generate BICs for SSI/SSP clients who are initially added to MEDS.

Note: A new BIC is not issued to SSI/SSP clients if they have already received a BIC under another MC program (i.e. a CalWORKs client continues to use the same BIC if he/she becomes SSI/SSP eligible).

Due to the weekly SDX transaction, it takes at least 5 business days for a newly approved SSI/SSP individual to receive a BIC and/or to have MC eligibility recorded into the CA-EV/CMS. Therefore, newly approved SSI/SSP clients who need emergency care must contact the EW to have their MC eligibility recorded on MEDS and/or a Paper Card /BIC issued Online.

When an SSI/SSP individual requests an immediate need MC Paper Card/ BIC, follow the procedure below:

SSI/SSP Initial BIC Issuance

  1. EW
    1. Verifies proof of SSI/SSP eligibility by any of the following:
      1. The SSI/SSP check for the month for which MC is requested.
      2. Documentation from the Social Security Administration (i.e. SCD 169)
      3. An SSI/SSP award letter received that month.
      4. Other proof of eligibility as specified by DHCS.
    2. If the HCP-type is an H or the OHC type is a P, determines if the client has a Prepaid Health Plan, if it is do not reissue an immediate need card. Follow up with DHCS- sent 9/14/16.
    3. Fills out a “Request for Online Transaction” (SCD 1296) to have SSI/SSP based MC eligibility recorded for eligible months, and/or a BIC/ Paper Card issued (indicate EW 15 on SCD 1296).
  2. CST
    1. Records SSI/SSP eligibility.
    2. Issues a Paper ID card and/or requests a BIC be sent, if appropriate.

      1. NOTE: In order to receive an immediate need Paper Card/BIC, the SSI/SSP individual must not be enrolled in a comprehensive Prepaid Health Plan (PHP) for the month for which MC eligibility is requested.

Note: If SSI/SSP based MC eligibility is requested for a period one year or more prior to the current month, the EW must follow the procedure to request a “Letter of Authorization”.

SSI/SSP BIC Replacement

A BIC can be replaced for a client who is currently SSI/SSP active on MEDS when:

  • The card was lost, damaged or stolen. An [INQM] screen from MEDS showing SSI/SSP eligibility is the only verification needed in these situations. No affidavit is required from the SSI/SSP client. A temporary Paper Card can be issued if an immediate need exists.
  • The BIC contained erroneous data (i.e. address, health coverage, birthdate). SSI clients reporting erroneous data on their cards can contact any EW to request BIC replacement. The following procedure must be followed:

SSI/SSP BIC Replacement

  1. EW    
    1. Advises the SSI/SSP client to report changes or incorrect information to their local SSA office.
  2. CST    
    1. Verifies proof of changes requested:
      1. Documentation from the Social Security Administration (SCD 169), or
      2. The “Social Security Administration Referral Notice” (MC 194) returned from SSA, or
      3. Other proof of changes as specified by DHCS.
    2. Completes a “Request for Online Transaction” (SCD 1296) requesting an EW 55 transaction to:
      1. Make the appropriate MEDS record changes, and
      2. Issue a replacement BIC/ Paper Card, if necessary.
    3. Updates the changes on MEDS and issues a replacement BIC/Paper Card, as requested.

Important: EWs must not change the address of an SSI/SSP client on MEDS without verification from the
Social Security Administration (i.e., SCD 169, SCD 1955 or phone confirmation). If the client’s Social Security address is not updated first, the system will default to the address where the SSI/SSP check is sent.

Related Topics

Medi-Cal Identification Cards

Non SSI/SSP Medi-Cal Identification Card Issuance