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Title 8: Medicaid Page 96 Iowa Department of Health and Human Services Employees’ Manual Chapter C: Nonfinancial Eligibility Nonfinancial Non-MAGI-Related Eligibility Revised October 10, 2025 Denial of Medicaid Based on Disability Denial Comment:

Ms. L applies for Medicaid based upon disability in February 2008. The IM worker refers Ms. L for a Department disability determination because she has resources higher than the limit for non-MAGI-related coverage groups but lower than the limit for the Medically Needy program. DDS evaluates Ms. L and determines that she does not meet the criteria for disability. Ms. L applies for SSDI in July 2008. The SSA denies that she is disabled. Ms. L asks for all levels of the SSA appeal process. In the final level of appeal, Ms. L is approved for disability effective May 2008. Although Ms. L is determined to be disabled by SSA, the Department requires a new application because the original denial was not based on the SSA disability denial. Reapplications Based on Disability Legal reference: 20 CFR 416.913, and 416.920; 441 IAC 50.2(1) and 75 (Rules in Process) Policy: The Department must reevaluate the disability status of an applicant each time a Medicaid application is filed. Procedure: Evaluate the current claim for disability when a person reapplies for Medicaid based on disability:  After a denial because the person was not determined to be disabled, or  After a cancellation due to the determination that the person is no longer disabled. See the following sections:  Reapplying After Disability Is Denied  Reapplying After Cancellation for a Nondisability Reason