Fla. Admin. Code Ann. R. 65A-1.710 - SSI-Related Medicaid Coverage Groups

The Department covers all mandatory coverage groups and the following optional coverage groups:

(1) MEDS-AD Demonstration Waiver. A Medicaid coverage group for aged or disabled individuals (or couples), as provided in 42 U.S.C. § 1396a(m).

(2) Institutional Care Program (ICP). A Medicaid coverage group that helps pay for the cost of care in a nursing facility for institutionalized aged, blind or disabled individuals (or couples) who would be eligible for cash assistance except for their institutional status and income as provided in 42 C.F.R. §§ 435.211 and 435.236.

(3) Hospice Program. A Medicaid coverage group that provides care and support to individuals who are terminally ill and meets the specific Medicaid hospice eligibilty requirements as provided in 42 U.S.C. § 1396d(a). subsection 65A-1.711(3) and Rule 65A-1.713, F.A.C.

(4) Home and Community Based Services (HCBS). A Medicaid coverage group for aged, blind or disabled individuals that provides coverage for services and activities to prevent institutionalization and allow the individual to remain in the community. The approved HCBS Waivers as permitted by 42 U.S.C. § 1396n and 42 C.F.R. § 435.217 are intended to prevent institutionalizing individuals who:

(a) Satisfy all SSI-Related Medicaid financial and non-financial eligibility criteria; and

(b) Have resources and income within Institutional Care or MEDS-AD Demonstration Waiver Program limits.

(5) Medically Needy Program. A Medicaid coverage group, as allowed by 42 U.S.C. §§ 1396a and 1396d, for aged, blind or disabled individuals (or couples) whose countable income exceeds the applicable Medically Needy Income Level (MNIL) in subsection 65A-1.716(2), F.A.C.

Notes

Fla. Admin. Code Ann. R. 65A-1.710

Rulemaking Authority 409.919 FS. Law Implemented 409.902, 409.903, 409.904, 409.906, 409.919 FS.

New 10-8-97, Amended 1-27-99, 4-1-03, 6-13-04, 8-10-06 (4), (6), 8-10-06 (6), (7), (8), 10-9-13, Amended by Florida Register Volume 45, Number 252, December 31, 2019 effective 1/12/2020.

New 10-8-97, Amended 1-27-99, 4-1-03, 6-13-04, 8-10-06 (4), (6), 8-10-06 (6), (7), (8), 10-9-13, 1-12-20.