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Table of Contents Coverage Groups ii 2030.0902 Children Under Age 19 (MFAM) ..................................................................... 10 2030.0903 Children Age 19 to 21 (MFAM) ....................................................................... 11 2030.1100 EMA TO INELIGIBLE NONCITIZENS (MFAM) ..................................................... 11 2030.1100.01 Coverage of Emergency Only (MFAM) .......................................................... 11 2030.1100.02 Exceptions to Medicaid Policy and Procedures (MFAM) ............................... 11 2030.1200 FORMER FOSTER CARE CHILDREN (MFAM) ................................................... 11 2030.1400 MEDICALLY NEEDY COVERAGE (MFAM).......................................................... 12 2040.0000 SSI-Related Medicaid, State Funded Programs ....... 12 2040.0100 CATEGORY CODES (MSSI) ................................................................................. 12 2040.0107 SSI-Related Medicaid Category Codes (MSSI) ............................................. 12 2040.0800 SSI-RELATED MEDICAID COVERAGE GROUPS (MSSI) .................................. 13 2040.0801.01 Supplementary Security Income Coverage Group (MSSI) ............................ 13 2040.0801.02 Identification by SSA of SSI-DA (MSSI) ......................................................... 13 2040.0801.03 Entitlement Due to Receipt of SSI (MSSI)...................................................... 13 2040.0801.04 Date of Entitlement for SSI Individuals (MSSI) .............................................. 14 2040.0801.05 Institutional Care SSI Eligible Except for Income (MSSI) ............................... 14 2040.0802.01 Protected Medicaid (MSSI) ............................................................................ 14 2040.0802.02 Aged Criteria for Protected Medicaid (MSSI) ................................................. 14 2040.0802.03 Disability/Blindness Requirement for Protected MA (MSSI) .......................... 15 2040.0802.04 Citizenship Requirement for Protected Medicaid (MSSI) ............................... 15 2040.0802.05 Residence (MSSI) .......................................................................................... 15 2040.0802.06 Assets (MSSI) ................................................................................................. 15 2040.0802.07 Income (MSSI) ................................................................................................ 15 2040.0802.08 Disregard of COLAs (MSSI) ........................................................................... 15 2040.0802.09 Disregard of the Title II COLAs (MSSI) .......................................................... 15 2040.0802.10 Budgeting (MSSI) ........................................................................................... 16 2040.0803 Ex Parte to Medically Needy (MSSI) .............................................................. 16 2040.0804.01 Regular COLA Protected Medicaid (MSSI) .................................................... 16 2040.0804.02 Effective Date of Coverage (MSSI) ................................................................ 16 2040.0805.01 Protected Medicaid for Disabled Widows(ers) I (MSSI) ................................. 16 2040.0805.02 Written Application Necessary for Widows(ers) I (MSSI) ............................... 16 2040.0805.03 Effective Date of Coverage for Widows(ers) I (MSSI) .................................... 17 2040.0805.04 Processing Application for Disabled Widows(ers) I (MSSI) ........................... 17 2040.0806.01 Individuals Who Lost SSI Due to Widows(ers) II (MSSI) ............................... 17 2040.0806.02 Date of Entitlement for Widows(ers) II (MSSI) ............................................... 17 2040.0807.01 Protected Medicaid for Disabled Widows(ers) III (MSSI) ............................... 17 2040.0807.02 Date of Entitlement for Widows(ers) III (MSSI) .............................................. 17 2040.0808 Protected Medicaid for Disabled Adult Children (MSSI) ................................ 17 2040.0809 Protected Medicaid for SSI Children (MSSI) .................................................. 18 2040.0810.01 Emergency Medicaid for Noncitizens (MSSI) ................................................. 18 2040.0810.02 Limited Coverage for Emergency Medicaid for Noncitizens (MSSI) .............. 18 2040.0810.03 Definition of a Noncitizen (MSSI) ................................................................... 19 2040.0810.04 Emergency Medical Condition (MSSI) ........................................................... 19 2040.0810.05 Technical Criteria for EMA (MSSI) ................................................................. 19 2040.0810.06 Financial Criteria - EMA (MSSI) ..................................................................... 19 2040.0810.07 Administrative Policy for EMA (MSSI) ............................................................ 19 2040.0812.01 Retroactive Medicaid (MSSI) .......................................................................... 19 2040.0812.02 Requirements for Retroactive Coverage (MSSI) ............................................ 19 2040.0812.03 Date of Entitlement for Retroactive Medicaid (MSSI) ..................................... 20