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Chapter: 2000 Coverage Groups Program: MSSI, SFP 22 To be eligible for HCBS, the individual must meet all SSI-Related technical criteria and have income and assets within the limits for ICP or MEDS-AD. Individuals cannot qualify for HCBS under the Medically Needy Program.

Effective January 1, 2020, the HCBS/Working People with Disabilities (WPwD) Program was implemented for individuals with earned income from paid employment or a combination of earned and unearned income to have higher income and asset limits than regular HCBS. Refer to 1640.0205 for the asset limit and 2440.0103 for the income limit. 2040.0815.03 Additional Criteria - HCBS Familial Dysautonomia Waiver (MSSI) For the Familial Dysautonomia (FD/HCBS) waiver individuals must:

1. be aged three or older (must meet disability criteria if under age 65); 2. meet a level of care for being at risk of hospitalization as determined by CARES; 3. have a diagnosis of Familial Dysautonomia and a need for medically necessary services provided by the waiver as determined by CARES; and 4. be enrolled in the Familial Dysautonomia waiver as documented by form CF-ES 2515 2040.0815.04 Additional Criteria - HCBS Individual Budgeting Florida (iBudget) Developmental Disabilities (MSSI) For the (iBudget) Developmental Services program individuals must:

1. be disabled or aged; 2. meet the appropriate level of care for an ICF/DD as determined by the Agency for Persons with Disabilities, and 3. be enrolled in the waiver as documented by form CF-ES 2515. 2040.0815.05 Additional Criteria - HCBS Model Waiver (MSSI) For the Model waiver, individuals must:

1. be under 21 years of age, 2. be diagnosed as having a degenerative spinocerebeller disease, 3. meet the appropriate level of care for inpatient hospital care as determined by Children’s Medical Services; and 4. be enrolled in the waiver through Children’s Medical Services as documented by form CF-ES 2515. 2040.0815.07 Additional Criteria HCBS Statewide Managed Medicaid Care Long Term Care (SMMC LTC) For Statewide Managed Medicaid Care Long Term Care (SMMC LTC), an individual must

1. be aged 65 years of age or older 2. be 18 years through 64 years of age and disabled 3. meet level of care requirement as determined by CARES 5. be enrolled in the waiver with specific managed care providers as documented by form CF-ES 2515 for HCBS services. 2040.0816 Working Disabled (MSSI) Most individuals with disabilities who work will continue to receive at least 93 consecutive months of hospital (Part A) and medical (Part B) insurance under Medicare. They pay no premium for Part A. After premium-free Medicare Part A coverage ends, they can continue receiving Medicare, as long as they remain medically disabled and continue to work, but must pay a premium for Part A. The state can pay the Medicare Part A premium for qualified individuals who meet all of the following eligibility criteria: