New Mexico Administrative Code

Some types of resources can be excluded from the calculation of countable resources if they meet the specific criteria listed below. A. Burial fund exclusion: Up to one thousand five hundred dollars ($1,500) can be excluded from the countable liquid resources of an applicant/reci…

A. Transfers of assets for less than fair market value by SSI applicants/recipients are considered only if/when an applicant/recipient becomes institutionalized. For medicaid categories using SSI resource determination methodology, transfers by non-institutionalized applicants/re…

In some instances, an applicant/recipient with a trust can be eligible for SSI cash benefits but not be automatically eligible for medicaid. If the social security administration (SSA) determines that an SSI recipient has a trust, SSI notifies the human services department (HSD) …

A. Deeming resources when an applicant/recipient lives with an ineligible spouse: If an eligible noninstitutionalized applicant/recipient lives in the same household with an ineligible spouse, the resources of the ineligible spouse are considered to belong to the applicant/recipi…

A. An applicant/recipient's gross countable monthly income must be less than the maximum allowable monthly standard for the applicable medicaid category. Income may be in the form of cash, checks, money orders, or in-kind, including personal property or food. If income is not rec…

See 8.200.520 NMAC and following subsections for income standards applicable to the SSI-related medicaid categories. A. Income exclusions: Income exclusions are applied before income disregards. Exclusions are applied in determining eligibility whether the income belongs to the a…

The rule applies to the general public.

A. Unearned income includes all income not earned in the course of employment or self-employment. B. Income paid to one spouse is considered the income of that spouse. One-half the total income paid to a couple is considered available to each member of the couple. (1) If payment …

A. Availability: Deemed income is income which must be considered available to members of an assistance unit regardless of whether the income is actually made available. B. Situations in which deeming occurs: For household member(s) who are not members of the assistance unit but …

Income disregards are allowed as described below when applicable. A. Child support payments: One-third of the amount of child support payments made to a child applicant/recipient is disregarded. The remainder is considered unearned income, subject to the appropriate disregards. B…

When computing an applicant/recipient's eligibility, the applicable income standard is that of the SSI-related category being applied for/received. See Section 8.200.520 NMAC and following subsections.

The New Mexico medicaid program is administered pursuant to regulations promulgated by the federal department of health and human services under Title XIX of the Social Security Act, as amended and by the state health care authority pursuant to state statute. See Section 27-2-12 …

Permanent.

March 1, 2018, unless a later date is cited at the end of a section.

The objective of these regulations is to provide eligibility policy and procedures for the medicaid program.

Relative: A son/daughter; grandson/granddaughter; step-son/step-daughter; in-laws; mother/father; step-mother/step-father; half sister/half brother; grandmother/grandfather; aunt/uncle; sister/brother; step-brother/step-sister; and niece/nephew.

To transform lives. Working with our partners, we design and deliver innovative, high quality health and human services that improve the security and promote independence for New Mexicans in their communities.

This section describes the methodology to be used in determining countable resources and income for medicaid eligibility categories which use supplemental security income (SSI) methodology. Medicaid eligibility is determined prospectively. Applicants/recipients must meet, or expe…

New Mexico Health Care Authority.

Retroactive medicaid coverage is provided in accordance with 8.200.400.14 NMAC.

A case is closed, with provision of advance notice when the recipient becomes ineligible. If a recipient dies, the case is closed the following month.

The rule applies to the general public.

The New Mexico medicaid program is administered pursuant to regulations promulgated by the federal department of health and human services under Title XIX of the Social Security Act, as amended and by the state health care authority pursuant to state statute. See Section 27-2-12 …

Permanent.

January 1, 2019, or upon a later approval date by the federal centers for medicare and medicaid services (CMS), unless a later date is cited at the end of the section.

The objective of these regulations is to provide eligibility policy and procedures for the medicaid program.

Medicaid coverage for services based on determinations made using the SSI methodology varies based on the category of eligibility. For applicants/recipients who are eligible for SSI, full medicaid coverage for services is available. If applicants/recipients are eligible for medic…

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