Medicaid Eligibility Handbook
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  4. 25.3 503 Group

State of Wisconsin
Department of Health Services

Release 26-02
April 15, 2026

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25.3 503 Group

  1. 25.3.1 Introduction
  2. 25.3.2 Identifying a 503 Group
  3. 25.3.3 Determining the COLA Disregard for 503 Group

25.3.1 Introduction

This group, named after section 503 of Public Law 94-566 extends Medicaid eligibility to certain former SSI recipients if they would be otherwise eligible for SSI benefits if all historical COLA increases to their Social Security benefits since SSI was lost were disregarded.

25.3.2 Identifying a 503 Group

Someone qualifies as a 503 group for Medicaid purposes if they meet the following criteria:

  1. They currently receive some type of Social Security benefits.
  2. They were previously eligible for SSI (or they were a 1619 participant) but became ineligible for SSI/1619 for any reason.
  3. In any month since April 1977, they were eligible for SSI/1619 benefits concurrently with Social Security benefits.

“Concurrently” includes situations in which Social Security benefits are granted retroactively for months in which the person was also receiving SSI. It also includes situations in which SSA recovered the SSI payment because the Social Security payment covers the same period for which the person received SSI. However, "concurrently" does not include situations in which SSI eligibility is granted retroactively for a period in which the person was also receiving Social Security benefits. To be considered a 503 group, a person must have received SSI income in the month prior to the month in which they began to receive the Social Security payment. Sometimes SSI and Social Security payments will be received in the same month, but not always.

Example  Kathy received both SSI and Social Security Surviving Spouse (SSSS) payments for the past five years. She lost her SSI payment due to an increase in unearned income when she began receiving a pension in January of this year. While a COLA increase was not the reason she lost SSI, because the SSI and SSSS payments were received concurrently and then she lost SSI, when her Medicaid eligibility is determined, Kathy is entitled to a disregard of all COLA increases to her SSSS payments since the date SSI was lost.

25.3.3 Determining the COLA Disregard for 503 Group

To calculate the COLA disregard for 503 groups:

  1. Find the gross Social Security income, which is the sum of the following:
    1. Net amount of the Social Security payment
    2. Any amount being deducted for Medicare premiums
    3. Any amount being withheld for other reasons (i.e., overpayments, garnishments) 
  2. In the “Month SSI Last Received” column in the table below, find the month in which the person was last eligible for and received an SSI payment.
  3. Find the decimal figure that applies to that month and the year the Social Security check was received.
  4. Multiply the gross Social Security income by the applicable decimal figure and round to the nearest whole dollar.
Note Once the disregard amount is determined and applied, going forward, all subsequent COLA increases will be disregarded automatically as part of the annual COLA mass change.
Month SSI Was Last Received Multiply 2026 Social Security by:  Multiply 2025 Social Security by:
Jan 2025 - Dec 2025 0.027237 --
Jan 2024 - Dec 2024  0.050963 0.024390 
Jan 2023 - Dec 2023  0.080391 0.054642 
Jan 2022 - Dec 2022  0.153993 0.130305 
Jan 2021 - Dec 2021  0.201127 0.178758 
Jan 2020 - Dec 2020  0.211379 0.189298 
Jan 2019 - Dec 2019  0.223798 0.202065 
Jan 2018 - Dec 2018  0.244940 0.223798 
Jan 2017 - Dec 2017  0.259745 0.239018 
Jan 2016 - Dec 2016  0.261959 0.241294 
Jan 2015 - Dec 2015  0.261959 0.241294 
Jan 2014 - Dec 2014  0.274296 0.253976 
Jan 2013 - Dec 2013  0.285021 0.265001 
Jan 2012 - Dec 2012  0.296972 0.277287 
Jan 2011 - Dec 2011  0.321402 0.302401 
Jan 2010 - Dec 2010  0.321402 0.302401 
Jan 2009 - Dec 2009  0.321402 0.302401 
Jan 2008 - Dec 2008  0.358603 0.340644 
Jan 2007 - Dec 2007  0.373023 0.355468 
Jan 2006 - Dec 2006  0.393053 0.376058 
Jan 2005 - Dec 2005  0.416957 0.400632 
Jan 2004 - Dec 2004  0.432286 0.416390 
Jan 2003 - Dec 2003  0.443962 0.428393 
Jan 2002 - Dec 2002  0.451639 0.436285
Jan 2001 - Dec 2001  0.465535 0.450570 
Jan 2000 - Dec 2000  0.483609 0.469150
Jan 1999 - Dec 1999  0.495712 0.481592 
Jan 1998 - Dec 1998  0.502184 0.488245
Jan 1997 - Dec 1997  0.512423 0.498771 
Jan 1996 - Dec 1996  0.526164 0.512897 
Jan 1995 - Dec 1995  0.538172 0.525240 
Jan 1994 - Dec 1994  0.550751 0.538172 
Jan 1993 - Dec 1993  0.562135 0.549875 
Jan 1992 - Dec 1992  0.574888 0.562985 
Jan 1991 - Dec 1991  0.590056 0.578578 
Jan 1990 - Dec 1990  0.611059 0.600169 
Jan 1989 - Dec 1989 0.628519 0.618117
Jan 1998 - Dec 1988 0.642806 0.632805
Jan 1987 - Dec 1987 0.657204 0.647606
Jan 1986 - Dec 1986 0.661603 0.652128
Jan 1985 - Dec 1985 0.671778 0.662588
Jan 1984 - Dec 1984 0.682877 0.673998
Jul 1983 - Dec 1983 0.693601 0.685022
Jul 1982 - Jun 1983 0.714712 0.706724
Jul 1981 - Jun 1982 0.743446 0.736263
Jul 1980 - Jun 1981 0.775544 0.769259
Jul 1979 - Jun 1980 0.795763 0.790045
Jul 1978 - Jun 1979 0.808228 0.802859
Apr 1977 - Jun 1978  0.818912 0.813842

This page last updated in Release Number: 26-01
Release Date: 02/13/2026
Effective Date: 01/01/2026

The information concerning the Medicaid program provided in this handbook release is published in accordance with: Titles XI and XIX of the Social Security Act; Parts 430 through 481 of Title 42 of the Code of Federal Regulations; Chapters 46 and 49 of the Wisconsin Statutes; and Chapters HA 3, DHS 2, 10 and 101 through 109 of the Wisconsin Administrative Code.

Notice: The content within this manual is the sole responsibility of the State of Wisconsin's Department of Health Services (DHS). This site will link to sites outside of DHS where appropriate. DHS is in no way responsible for the content of sites outside of DHS.

Publication Number: P-10030