42 CFR 435.230 - Aged, blind, and disabled individuals in States that use more restrictive requirements for Medicaid than SSI requirements: Optional coverage.
(a)Basic optional coverage rule. If the agency elects the option under § 435.121 to provide mandatory eligibility for aged, blind, and disabled SSI beneficiaries using more restrictive requirements than those used under SSI, the agency may provide eligibility as optional categorically needy to additional individuals who meet the requirements of this section.
(1) Individuals who are financially eligible for but not receiving SSI benefits and who, before deduction of incurred medical and remedial expenses, meet the State's more restrictive eligibility requirements described in § 435.121;
(2) Individuals who meet the income standards of the following eligibility groups:
(i) Individuals who would be eligible for cash assistance except for institutional status described in § 435.211;
(ii) Individuals who are enrolled in an HMO or other entity and who are deemed to continue to be Medicaid eligible for a period specified by the agency up to 6 months from the date of enrollment and who became ineligible during the specified enrollment period, as described in § 435.212;
(iii) Individuals receiving home and community-based waiver services described in § 435.217;
(v) Institutionalized individuals with income below a special income level described in § 435.236;
(3) Individuals who qualify for special status under §§ 435.135 and 435.138, and with respect to whom the State elects to disregard some or the maximum amount of title II payments permitted to be disregarded under those sections.
- 42 CFR 435.201 — Individuals Included in Optional Groups.
- 42 CFR 435.401 — General Rules.
- 42 CFR 435.726 — Post-Eligibility Treatment of Income of Individuals Receiving Home and Community-Based Services Furnished Under a Waiver: Application of Patient Income to the Cost of Care.
- 42 CFR 435.631 — General Requirements for Determining Income Eligibility in States Using More Restrictive Requirements for Medicaid Than SSI.
- 42 CFR 435.330 — Medically Needy Coverage of the Aged, Blind, and Disabled in States Using More Restrictive Eligibility Requirements for Medicaid Than Those Used Under SSI.
- 42 CFR 435.725 — Post-Eligibility Treatment of Income of Institutionalized Individuals in SSI States: Application of Patient Income to the Cost of Care.
- 42 CFR 435.832 — Post-Eligibility Treatment of Income of Institutionalized Individuals: Application of Patient Income to the Cost of Care.
- 42 CFR 435.909 — Automatic Entitlement to Medicaid Following a Determination of Eligibility Under Other Programs.