Chapter 02-02.1. Eligibility for Medicaid

Effective for the benefit month of January 2014, the following MAGI-based methodology will be used in determining income eligibility for Medicaid. 1. Income is based on household composition. 2. Monthly income is used prospectively for new applications; annualized income is used …

1. For purposes of this section, "biweekly" means every two weeks. 2. Income received either weekly or biweekly must be converted to monthly income in determining the household's countable income under MAGI-based methodology. Income must be received each week for those paid weekl…

methodology. 1. For purposes of this section, "reasonable compatibility" refers to an allowable difference or discrepancy between the income reported by an applicant or recipient and the income reported by an electronic data source. 2. The department may request additional inform…

Repealed effective December 1, 1991.

Repealed effective July 1, 2003.

Unearned income is income that is not earned income. Unearned income received in a fixed amount each month shall be applied in the month in which it is normally received. The following income rules apply to individuals not subject to a MAGI-based methodology: 1. Recurring unearne…

Unearned income is income that is not earned income. Unearned income received in a fixed amount each month shall be applied in the month in which it is normally received. Effective January 1, 2014, individuals subject to a MAGI-based methodology will have income treated as follow…

Earned income is income that is currently received as wages, salaries, commissions, or profits from activities in which an individual or family is engaged through either employment or self-employment. Income is "earned" only if the individual or family contributes an appreciable …

Except in determining eligibility for workers with disabilities or children with disabilities, this section prescribes specific financial requirements for determining the treatment of income and application of income to the cost of care for an individual screened as requiring nur…

This section applies to an individual residing in the individual's own home or in a specialized facility, workers with disabilities coverage, children with disabilities coverage, and to the Medicare savings programs, but does not apply to an individual receiving nursing care serv…

methodology. This section applies to an individual residing in the individual's own home or in a specialized facility, workers with disabilities coverage, children with disabilities coverage, and to the Medicare savings programs, but does not apply to an individual receiving nurs…

Earned income is income that is currently received as wages, salaries, commissions, or profits from activities in which an individual or family is engaged through either employment or self-employment. Income is "earned" only if the individual or family contributes an appreciable …

This section applies to an individual residing in the individual's own home or in a specialized facility, workers with disabilities coverage, children with disabilities coverage, and to the Medicare savings programs, but does not apply to an individual receiving nursing care serv…

1. The department shall use levels of income for maintenance as a basis for establishing financial eligibility for Medicaid. The income levels applicable to individuals and units are: a. Categorically needy income levels. (1) Family coverage income levels established in the Medic…

Excess income is the amount of net income remaining after allowing the appropriate disregards, deductions, and Medicaid income level. 1. Twenty-five percent of the excess income of an ineligible Medicaid unit shall be deemed available during any full calendar month an eligible me…

Recipient liability is the amount of monthly net income remaining after all appropriate deductions, disregards, and Medicaid income levels have been allowed. All such income must be considered to be available for the payment of medical services provided to the eligible individual…

1. Definitions. For purposes of this section: a. "Base month" means the calendar month prior to the processing month. 93 b. "Benefit month" means the calendar month for which eligibility and recipient liability is being computed. c. "Best estimate" means an income, expense, or ci…

No individual may be determined to be ineligible for Medicaid for any month if, had the approved state plan for medical assistance in effect on January 1, 1972, been in effect in such month, that individual would be eligible. The following income and resource standards were a par…

1. For purposes of determining an individual's eligibility under this chapter, if payment is made by the individual to the individual's attorney-in-fact for services or assistance furnished to the individual by the attorney-in-fact, the department may not treat the services or as…

1. Children ages birth through eighteen years of age are eligible for plan coverage provided all other eligibility criteria are met. Coverage for children who are eighteen years of age will continue through the last day of the month in which the child turns nineteen years of age.…