37.82.901    GROUPS COVERED, NON-INSTITUTIONALIZED SSI-RELATED INDIVIDUALS AND COUPLES

(1) Medicaid will be provided to:

(a) Aged, blind or disabled individuals or couples receiving SSI, including:

(i) those receiving SSI pending final determination of blindness or disability;

(ii) those receiving SSI under an agreement with the social security administration to dispose of resources that exceed the SSI dollar limits on resources; and

(iii) those deemed to be receiving SSI under the special SSI eligibility status granted by the social security administration to certain severely impaired individuals who work.

(b) Aged, blind or disabled individuals or couples receiving mandatory state supplements.

(c) Aged, blind or disabled individuals or couples receiving only a state supplementary payment (but no SSI payment) under the optional state supplementary program established in ARM 37.43.101 through 37.43.104.

(2) Medicaid will also be provided to aged, blind or disabled individuals or couples who are not receiving SSI. This coverage is limited to:

(a) Individuals who would be eligible for SSI had they applied.

(b) Individuals who, in August 1972, were eligible for OASDI and who were also receiving OAA, AB, APTD, or AABD or would have been receiving such cash assistance had they applied, providing:

(i) they meet all current SSI non-financial requirements identified as applicable to medicaid eligibility in ARM 37.82.902;

(ii) they meet all current SSI resource limitations identified as applicable to medicaid eligibility in ARM 37.82.903; and

(iii) they would currently be eligible for an SSI payment if the increase in OASDI benefits on July 1, 1972 had not raised individual or couple income over the SSI income standards identified as applicable to medicaid eligibility in ARM 37.82.903.

(c) Individuals who are receiving OASDI and were receiving SSI but became ineligible due solely to a cost-of-living increase in OASDI paid under section 215(i) of the Social Security Act after April 1977, providing they would still be eligible for SSI if such increases were excluded from income.

(d) Individuals who would currently be eligible for an SSI payment if the January 1, 1984, increase in social security retirement benefits for disabled widows or widowers had not raised the individual income over the SSI income standards identified as applicable to medicaid eligibility in ARM 37.82.903.

(e) Widow(er)s who no longer receive SSI benefits or state supplemental payments as a result of becoming entitled to and receiving Title II benefits. Coverage is limited to individuals who are:

(i) between the ages of 60 and 65;

(ii) eligible for and receiving early widow(er) 's benefits from social security;

(iii) ineligible for SSI benefits or state supplemental payments due to receipt of social security early widow(er) 's benefits; and

(iv) not entitled to medicare Part A (hospital insurance) .

(3) Medicaid will also be provided to aged, blind or disabled individuals or couples who are not receiving a state supplementary payment under the optional state supplementary program. This coverage is limited to:

(a) Individuals who, in August 1972, were eligible for OASDI and who were also receiving OAA, AB, APTD, or AABD or would have been receiving such cash assistance had they applied, providing:

(i) they meet all current optional state supplementary program non-financial requirements identified as applicable to medicaid eligibility in ARM 37.82.902;

(ii) they meet all current optional state supplementary program resource limitations identified as applicable to medicaid eligibility in ARM 37.82.903; and

(iii) they would currently be eligible for a state supplementary payment if the increase in OASDI benefits on July 1, 1972 had not raised individual or couple income over the optional state supplementary program income standards identified as applicable to medicaid eligibility in ARM 37.82.903.

(b) Individuals who are receiving OASDI and were receiving a state supplementary payment under the optional state supplementary program but became ineligible due solely to a cost-of-living increase in OASDI paid under section 215(i) of the Social Security Act after April 1977, providing they would still be eligible for a state supplementary payment if such increases were excluded from income.

(4) Finally, medicaid will be provided to individuals who were eligible for medicaid in December 1973. This coverage is limited to:

(a) Individuals who in December 1973 were eligible for medicaid as an essential spouse of a recipient of OAA, AB, APTD, or AABD, providing:

(i) the spouse has continued to live with and be essential to the well being of the former recipient of OAA, AB, APTD, or AABD;

(ii) the former recipient of OAA, AB, APTD, or AABD continues to meet the December 1973 eligibility requirements; and

(iii) the spouse continues to meet the December 1973 requirements for having his needs included in computing the cash payment available in December 1973.

(b) Individuals who meet all current SSI non-financial and financial requirements identified as applicable to medicaid eligibility in ARM 37.82.902 and 37.82.903 except the blindness or disability criteria, providing:

(i) they were eligible for medicaid in December 1973 as blind or disabled; and

(ii) for each consecutive month after December 1973, they continue to meet not only the December 1973 blindness or disability criteria, but also all other December 1973 eligibility criteria.

(5) Medicaid will be provided to a disabled widow, disabled widower or disabled surviving divorced spouse who loses supplemental security income benefits or state supplemental payments and therefore medicaid eligibility because the person is determined to be eligible for social security, if the person meets the following criteria:

(a) The person was eligible for supplemental security income or state supplemental payments the month before the person began receiving social security benefits;

(b) The person would continue receiving supplemental security income or state supplemental payments if the person's social security benefit was not counted as income; and

(c) The person is not entitled to enroll in the hospital insurance plan (Part A) of medicare.

History: Sec. 53-6-113, MCA; IMP, Sec. 53-6-131, MCA; NEW, 1982 MAR p. 729, Eff. 4/16/82; AMD, 1987 MAR p. 208, Eff. 2/27/87; AMD, 1988 MAR p. 2231, Eff. 10/14/88; AMD, 1991 MAR p. 1049, Eff. 6/28/91; TRANS, from SRS, 2000 MAR p. 476.