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Title 8: Medicaid Page 73 Iowa Department of Health and Human Services Employees’ Manual Chapter F: Coverage Groups Non-MAGI-Related Coverage Groups Revised October 10, 2025 People Ineligible for SSI (or SSA) People Ineligible for SSI (or SSA) Several coverage groups provide Medicaid to people who are ineligible for SSI or State Supplementary Assistance benefits due to specific circumstances. The following sections explain coverage requirements for people who are ineligible due to:  Requirements that do not apply to Medicaid.  Receipt of a social security cost-of-living adjustment.  Receipt by a disabled adult of social security benefits from a parent’s account.  Receipt of the 20% social security increase of October 1972.  Substantial gainful activity.  The January 1984 actuarial change in determining widow’s or widower’s benefits.  Receipt of widow’s or survivor’s social security benefits. Due to Requirements That Do Not Apply to Medicaid Legal reference: 42 CFR 435.122, 441 IAC 75 (Rules in Process) Medicaid is available to people who would be eligible for SSI except that they do not meet an SSI requirement that is specifically prohibited in the Medicaid program. The client must meet all other Medicaid eligibility requirements. For example, for a person living in a public medical institution to be eligible for SSI, Medicaid must be paying at least 50% of the cost of care. Since Medicaid does not pay 50% of the cost of care for everyone, some people lose SSI. If these people meet all other eligibility factors, Medicaid eligibility continues under this coverage group. Count the resources of applicable household members when determining eligibility of either children or adults in this coverage group. Exception: Persons between age 21 and 65 who live in a mental health institute or facility for psychiatric care are not eligible under this coverage group.