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MEDICAL SERVICES POLICY MANUAL,SECTION O O-100 Medically Needy Program O 150 Special Cases Medically Needy
3. An individual denied or apparently not eligible for the U-18 category will be considered for Medicaid eligibility under the Medically Needy Program as “Spend Down”. 4. Foster children (Re. MS K-100) will be considered for eligibility in the Foster Care-EC, Foster Care MN-Spend down, if not eligible in Non-IV-E Foster Care, IV-E Foster Care or ARKids.
O-150 Special Cases - Medically Needy MS Manual 01/01/14 Special Cases - Medically Needy 1. If an individual and spouse both qualify under the same or different SSI- related categories of the Medically Needy Program their categorical relatedness will be established separately; however, their income, resources, and medical expenses will be counted in each spouse’s case and eligibility established on that basis. Each individual will be certified in a separate case. 2. When a family unit includes an SSI recipient(s), the SSI recipient’s income, resources, and medical expenses are excluded from eligibility considerations. Only the income, resources, and medical expenses of the remaining family members are used in establishing Medically Needy eligibility. For purposes of Medically Needy eligibility the SSI recipient(s) is not included in the family count. 3. If there is a TEA cash ineligible child under the age of 18 living with a TEA cash family, the child can be considered for ARKids and if not eligible for ARKids, can be considered for U-18 Medically Needy.
O-160 Definition of Medically Needy Program Terms MS Manual 01/01/14 The following sections of policy define terms that will be used within the Medically Needy policy section.
O-161 Medically Needy Income Level (MNIL) MS Manual 01/01/14 The MNIL is the income standard used to determine an individual’s or family’s eligibility for Medically Needy program benefits. An individual or family is considered to be Exceptional Medically Needy if their net income is at or below the maximum specified for their family size.