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Chapter: 0200 General Program Information Program: MSSI, SFP 10

1. Income Limit: 300% of the SSI Federal Benefit Rate

Note: Applicants or recipients whose income exceeds 300% of the SSI FBR may establish an income trust in order to qualify for Medicaid. 2. Asset Limit:

a. Individual: $2000 (special asset rules apply when there is a spouse living in the community) b. Couple: $3000 (transfer of asset provision applies)

3. Special Criteria: Level of Care: Must be in need of institutional care as determined by CARES.

4. Placement: Must be appropriately placed in a Medicaid facility able to provide the level of care needed. 0240.0108 MEDS-Aged/Disabled (MSSI) MEDS-AD provides Medicaid benefits (and institutional benefits, if needed) for eligible individuals who meet all technical requirements as well as the following:

1. Income Limit: 88% of Federal Poverty Level. 2. Asset Limit: $5000 (Individual), $6,000 (Couple).

Note: If the individual enters an institution, the transfer of assets provision applies. 0240.0109 Protected Medicaid (MSSI) This program ensures (or protects) ongoing Medicaid coverage for certain groups of former SSI recipients who would be eligible for SSI except for certain changes in their Social Security benefits.

There are five Protected Medicaid coverage groups:

1. Regular COLA, 2. Disabled Widow(er)s I, 3. Disabled Widow(er)s II, 4. Disabled Widow(er)s III, 5. Disabled Adult Children, and 6. SSI Children (See Chapter 2000). 0240.0110 Hospice (MSSI) The Hospice Program provides special services for the care of an individual who has a medical prognosis of terminally ill. An individual is considered to be terminally ill if they have a medical prognosis of life expectancy of six months or less, if the illness runs its normal course. If the individual is not already Medicaid eligible, he must meet all technical criteria and have income and assets within the limits for ICP, MEDS-AD or MN. In addition, all persons must meet certain special criteria.

The special criteria include a prognosis of terminal illness, certified by a medical statement, and an election statement from the individual stating that he chooses the Hospice Program to the exclusion of other Medicaid services unrelated to the terminal illness. The certification of the individual’s terminal illness shall be based on the physician’s or medical director’s judgment regarding the normal course of the individual’s illness.