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Any child under age 21for whom there is an adoption assistance agreement in effect under Title IV-E of the Social Security Act is eligible for MA. The child is eligible for MA in the state where s/he is physically present even if the adoption assistance agreement is with another state. The adoption assistance agreement need not provide for an actual adoption assistance payment.

AX: An AX unit always contains a child under the age of 19, a parent or a caretaker (related or unrelated) of a child under the age of 19 who is eligible for Medicaid, or a pregnant woman. All parents, caretakers, pregnant women and children under the age of 19 must first be evaluated to determine if they are eligible under the AR program type. If the individual is aged, disabled and/or an SSI recipient, s/he must be evaluated under the SR program type before determining eligibility as part of an AX unit.

There are no mandatory group members for this type of unit.

SR: A person eligible for MA in an SR unit must be:

 age 65 or older,  blind, or  permanently and totally disabled.

A person who is blind or permanently and totally disabled can be any age from newborn to age 65. After age 65, the person's medical condition is no longer relevant because the person meets the age criteria.

The only mandatory group member is a spouse if s/he is also aged, blind, or disabled. If only one spouse is aged, blind, or disabled, then the other spouse is not included in the SR unit.

There are never more than two people in an SR unit. The only time there are two in the unit is when the two people are married to each other, are living together, and are aged, blind, or disabled. An SR unit always consists of either a married couple who are living together or an individual. An SR unit will never consist of a disabled parent and a disabled child. If a parent and a child are both disabled, they are considered two separate SR units.

Example Mr. and Mrs. Drew have one daughter, Rebecca, who is 14. Mrs. Drew is blind. All three family members apply for MA. Mrs. Drew has the option of being included in her own SR unit or in a unit with Rebecca. Mr. Drew should be included in a unit with Rebecca and, if she chooses, Mrs. Drew. Suppose Mrs. Drew and Rebecca have no income, Mr. Drew earns $1,000 per month, and the family incurs no child care costs. If all three are included in the same assistance unit and tested under the AR category, Rebecca will be found eligible (since the family’s income is below 100 percent of the FPL for a family of three). If both Mr. and Mrs. Drew chose to be in the same unit with Rebecca, both would be tested under the AX criteria. Rebecca would be included provisionally in the AX unit, and Mr. and Mrs. Drew would be found eligible for Medicaid (since their family’s income is below 200 percent of the FPL). Mrs. Drew could choose to be in her own SR unit. By doing so, she would not be placed in managed care because disabled Medicaid recipients are not required to enroll in the managed care system. Because the general managed care organizations may not meet the needs of disabled individuals, individuals with disabilities should be strongly encouraged to complete the medical evaluation form. If the MRT determines the individual disabled, the individual can be switched from an AR or AX unit to an SR unit.