Optional eligibility for individuals who would be eligible for cash assistance if they were not in medical institutions.

  1. Law
  2. CFR 42
  3. Public Health
  4. Centers for Medicare & Medicaid Services, Department of Health and Human Services
  5. Medical Assistance Programs
  6. Eligibility in the States, District of Columbia, the Northern Mariana Islands, and American Samoa
  7. Options for Coverage
  8. Options for Coverage of Families and Children and the Aged, Blind, and Disabled
  9. Optional eligibility for individuals who would be eligible for cash assistance if they were not in medical institutions.

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§ 435.211 Optional eligibility for individuals who would be eligible for cash assistance if they were not in medical institutions.

(a) Basis. This section implements section 1902(a)(10)(A)(ii)(IV) of the Act.

(b) Eligibility. The agency may provide Medicaid to any group or groups of individuals specified in § 435.201(a)(1) through (3) who are institutionalized in a title XIX reimbursable medical institution and who:

(1) Are ineligible for the SSI or an optional State supplement program in States that provide Medicaid to optional State supplement recipients, because of lower income standards used under the program to determine eligibility for institutionalized individuals; but

(2) Would be eligible for aid or assistance under SSI or an optional State supplement program (as specified in § 435.232 or § 435.234) if they were not institutionalized.

[81 FR 86452, Nov. 30, 2016]


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