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Title 8: Medicaid Page 92 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 When the Department Denies Disability Legal reference: 441 IAC 50.1(249), 50.2(1), 75 (Rules in Process) Policy: Medicaid eligibility based on disability shall be denied or canceled when the Department determines that an applicant or member is not disabled. Comment: When there is a DDS denial of disability, DDS issues the decision using form 470-2463, Explanation of Disability Determination or a Personalized Disability Explanation. The form is sent to the IM worker along with the entire disability file. The finding that the client is not disabled is also entered in Part II, 2 of the Disability Transmittal, form 470-2472. Procedure: Send the client:  A copy of form 470-2463, Explanation of Disability Determination or the Personalized Disability Explanation and  A Notice of Action denying the application or cancelling assistance because the person is not disabled. For an applicant, it is important to issue a manual Notice of Action using the following language.

…you are not blind or disabled. You will get a separate letter that tells you about the disability decision. EM 6-B SSA Policies Applicable to All Programs; EM 8-C Presence of Age, Blindness, or Disability; EM 8-J SSI-Related Medically Needy; EM 8-J Age Criteria; 8-J Blindness Criteria; EM 8-J Disability Criteria; 441 Iowa Admin. Code 50.1(249), 50.2(1), 75 (Rules in Process). If a member’s disability is denied due to a review of disability or due to a redetermination of disability for an 18-year-old using adult criteria, cancel the Medicaid coverage group and redetermine to another coverage group. Comment: For more information, see:  Appeal of a Medicaid Denial Based on a Disability Denial  When SSA Denies Disability After HHS Disability Approval  When SSA Denial Is Reversed in an SSA Appeal  Disability Reviews  Redetermination at Age 18