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September 7, 2017

c. The RCAP resident must also meet at least one of the following categorical eligibility requirements:  AGED- must be 65 years of age or older;

 BLIND- The degree of blindness is determined by the FSSA Medical Review Team (MRT) based on a visual exam, unless both eyes are missing, applicant receives SSI based upon blindness, eligibility has previously been established under Medicaid Blind ( MA B category).The client also must be at least 18 years of age; or

 DISABLED- Disability is determined by the MRT based upon social and medical information. The client also must be at least 18 years of age. Physical exam is required unless:  The applicant is receiving Social Security Income based upon disability;  The MRT has previously established eligibility and required no progress report.

 The RCAP applicant has the responsibility of furnishing all information necessary to determine eligibility. The Division Family Resources caseworker has the responsibility of verify all eligibility requirements.

3. Who determines Medicaid eligibility for an RCAP client?

a. Division of Family Resources local offices determines Medicaid eligibility and the resident’s income eligibility;

b. When an applicant has been determined eligible for RCAP, the DFR caseworker will submit assistance to residents in County Homes/Room and Board Assistance Budget and Recommendation form (5B) to the Division of Aging.

4. Are RCAP applicants limited to the current income level requirements for Medicaid? Potential RCAP applicants are not limited to the $973 income level when applying for Medicaid and are considered Medicaid eligible if they meet the following requirements: a. Applicant must meet the approved criteria to be classified in one of the following categories: aged, blind or disabled and must also meet the asset test;

b. Applicant’s gross monthly income cannot exceed $1,501.06 if residing in a licensed RCAP facility;