Page 72

Title 8: Medicaid Page 68 Iowa Department of Health and Human Services Employees’ Manual Chapter C: Nonfinancial Eligibility Nonfinancial Non-MAGI-Related Eligibility Revised October 10, 2025 When the Department Follows an SSA Disability… 2. Approve the case under SSI Medicaid. Determine eligibility for the retroactive period, as defined in 8-A, Definitions, only after the final disability determination has been made. Manually issue a Notice of Action using the following language:

Social Security found _______ to be presumptively eligible for disability. Medicaid is approved **/**/** through **/**/**. You will keep getting Medicaid after this date if Social Security finds you are disabled. Your Medicaid will end if Social Security finds that you are not disabled. EM 8-C Presumptive Disability; 20 CFR 416.931-933, 441 Iowa Admin. Code 50.2(1), 75 (Rules in Process). 3. When SSA makes the final determination that the person is disabled, establish ongoing eligibility for Medicaid benefits under the applicable coverage group. If the final decision is that the person was disabled during the retroactive period, as defined in 8-A, Definitions, issue a manual Notice of Action identifying:  Approval of ongoing eligibility.  Months of retroactive eligibility.  Any other months of eligibility when presumptive benefits were not received. 4. If SSA determines during the six-month presumptive period that the person is not permanently disabled, or if there is no decision by the end of the six-month period, cancel the case because SSA did not establish permanent disability. Manually issue a Notice of Action using the following language:

____ is not blind or disabled. The Social Security Administration denied benefits as you are not disabled at this time. We are required to follow Social Security’s decision. If you are approved for disability benefits at a later date, please tell us within 10 days of the date on your notice from Social Security. EM 8-C Denial Based on Disability; 441 Iowa Admin. Code 75 (Rules in Process) Determine if Medicaid eligibility exists under another coverage group.