477 Neb. Admin. Code, ch. 25, § 002 - ELIGIBILITY FOR THE MEDICALLY NEEDY
002.01
WHEN APPLICABLE. Children, parents or caretaker relatives, pregnant women, and the aged, blind, and disabled who have income above the limit for categorical eligibility may be eligible for Medicaid with a share of cost if a medical need exists or can be reasonably expected to exist. A medical need exists if medical costs for the financial unit exceed the Medically Needy Income Limit (MNIL) for the unit size.
002.02
BUDGET. A budget or system must be used to determine eligibility for medically needy individuals. Each month is determined separately. If an individual is eligible for one day of the month, then that person is considered to be eligible for the entire month. If at any time factors change that affect eligibility, then eligibility must be re-determined.
002.03
METHODOLOGY USED. The methodology used for the medically needy is based upon the most closely related cash assistance methodology. Income is counted in accordance with 477 Nebraska Administrative Code (NAC) 22. Resources are counted in accordance with 477 NAC 23.
002.03(A)
MEDICALLY NEEDY CHILDREN, FAMILIES, AND PREGNANT WOMEN. The treatment of income and resources for medically needy children, parents or caretaker relatives, and pregnant women is based on § 1931 of the Social Security Act.
002.03(B)
MEDICALLY NEEDY AGED, BLIND, AND DISABLED. The treatment of income and resources for individuals who are aged, blind, or disabled is based on the methodology of the Supplemental Security Income (SSI) program.
002.04
STANDARD LEVELS. When computing a budget for medically needy individuals, the unit or family size is determined according to 477 NAC 24.
Notes
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002.01 WHEN APPLICABLE. Children, parents or caretaker relatives, pregnant women, and the aged, blind, and disabled who have income above the limit for categorical eligibility may be eligible for Medicaid with a share of cost if a medical need exists or can be reasonably expected to exist. A medical need exists if medical costs for the financial unit exceed the Medically Needy Income Limit (MNIL) for the unit size.
002.02 BUDGET. A budget or system must be used to determine eligibility for medically needy individuals. Each month is determined separately. If an individual is eligible for one day of the month, then that person is considered to be eligible for the entire month. If at any time factors change that affect eligibility, then eligibility must be re-determined.
002.03 METHODOLOGY USED. The methodology used for the medically needy is based upon the most closely related cash assistance methodology. Income is counted in accordance with 477 Nebraska Administrative Code (NAC) 22. Resources are counted in accordance with 477 NAC 23.
002.03(A) MEDICALLY NEEDY CHILDREN, FAMILIES, AND PREGNANT WOMEN. The treatment of income and resources for medically needy children, parents or caretaker relatives, and pregnant women is based on § 1931 of the Social Security Act.
002.03(B) MEDICALLY NEEDY AGED, BLIND, AND DISABLED. The treatment of income and resources for individuals who are aged, blind, or disabled is based on the methodology of the Supplemental Security Income (SSI) program.
002.04 STANDARD LEVELS. When computing a budget for medically needy individuals, the unit or family size is determined according to 477 NAC 24.