Adult Medicaid Manual MA-500 CLASSIFICATION

REVISED 11/01/09 – CHANGE NO. 17-09

I. AGED, BLIND, AND DISABLED MEDICAID CLASSIFICATIONS

Only individuals receiving Medicaid under the Aged, Blind and Disabled aid/program categories are described in item I.

NOTE: Refer to the EIS Manual for special classifications codes for aged, blind, and disabled aliens.

A. Categorically Needy (C)

1. The following individuals are classified as Categorically Needy (Refer to MA-1000, SSI Medicaid, Automated Process.):

a. Individuals who receive SSI,

b. Individuals who receive SSI under Section 1619(a) and 1619(b), and

c. Individuals who receive Special Assistance for the Blind (M-SB).

2. Classification code in EIS is “C” (or “Q”, if dually eligible). EIS sets the classification code. The IMC cannot change this code.

B. Categorically Needy - No Money Payment (N)

1. The following individuals are classified as Categorically Needy - No Money Payment (Refer to MA-2100, Categorically Needy – No Money Payment):

a. Individuals who do not receive SSI and who have countable income equal or below 100% of the Federal Poverty Level and countable resources below the SSI limits.

b. Individuals protected by the Passalong provision. These individuals are “deemed” to be SSI recipients.

c. Individuals covered under the Health Coverage for Workers with Disabilities (HCWD) program with income less than or equal to 150% of Federal Poverty Level (FPL).

2. Classification code in EIS is “N” (or “Q”, if dually eligible as MQB-Q). For HCWD the classification code is “N” or “G” (or “Q” or “B”, if dually eligible and meet Q or B income and reserve requirements).

3. For special classification codes for aliens, see the EIS Manual.

REISSUED 11/01/09 – CHANGE NO. 17-09

(I.)

C. Medically Needy (M)

1. Individuals with income and/or resources that exceed the categorically needy levels are classified as Medically Needy. Refer to MA-2120, Medically Needy Regulations.

2. When the income exceeds 100% of the Federal Poverty Level, the individual must “spend down” to the medically needy income limit before he is eligible for Medicaid.

3. Classification code in EIS is “M” (or “B” if dually eligible as MQB-B).

4. For special classification codes for aliens, see the EIS Manual.