Page 78

Title 8: Medicaid Page 74 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… To cancel the Medicaid case, use the language below.

The Social Security Administration has determined that ____ is no longer disabled. EM 8-C Denial Based on Disability; 441 Iowa Admin. Code 75 (Rules in Process) See also:  Reapplying After Cancellation for a Nondisability Reason  SSA Disability Denial and Appeal Process  8-F, People Ineligible for SSI (or SSA): Due to Reevaluation of Childhood Disability

Mr. C is determined eligible for Medicaid in November based on the Department’s disability determination. In April of the following year, Mr. C applies for SSI but on June 5, he is denied SSI as not disabled. The worker continues Mr. C’s Medicaid eligibility for 65 days until the time to appeal has expired (August 8). As of August 8, Mr. C has not filed an appeal. On August 9, the worker issues a timely notice canceling Medicaid benefits for Mr. C effective September 1 and determines if Mr C would be Medicaid eligible under another coverage group. When the Department Determines Disability Legal reference: 20 CFR 416.901, 416.971, 416.972, 416.973; 441 IAC 75 (Rules in Process) Policy: The Department must determine an applicant’s disability when the applicant:  Is applying for a coverage group that requires a determination of disability according to Social security Administration (SSA) standards, and  Has not been approved for disability through an SSA disability determination. The Department must make a determination on disability within 90 calendar days of the date of application. The time can exceed 90 calendar days if:  The applicant or examining physician causes a delay, or  There is an emergency beyond the control of the Department or the applicant.