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COMAR 10.09.24.03

326 State of Maryland Medical Assistance Manual Revised July 2012 ABD, whose resources are within the MA community MN resource standard but whose income exceeds the medically needy income standard, qualify for federally matched MA when they spend-down their excess income-i.e., when their incurred medical expenses equal the amount of income that exceeded the income standard. Individuals eligible under MA spend-down may not be enrolled in HealthChoice. Aged A person who is 65 years of age or older Aged is reached the day of the anniversary of birth LDSS can accept the SSA determination of age for persons receiving SSB

Blind

A person shall meet the definition of Blindness, according to COMAR 10.09.02b which states a condition in which a person is certified by an ophthalmologist as having either central vision acuity 20/200 or less in the better eye with correcting glasses, or defect in which the peripheral filed has contracted to such an extent that the diameter of the field visual test subtends an angular distance of no greater than 20 degrees or Missing both eyes.

Disabled

Disability determination must be made by the SSA or the State Review Team (SRT). SRT is a unit within the DHR. DHR/FIA responsible for making a disability determination To be determined disabled, a person must have a disability that is expected to last at least 12 months or may result in death The determination by SSA is binding on the State until it is changed by the SSA

ABD Eligibility Criteria

Recipients of SSI from the SSA are automatically eligible for Medicaid. Individuals who lost SSI eligibility due to an annual cost of living increase in their Social Security income or a change in the federal disability definition are eligible for Medicaid. Individuals qualify as ABD MN, if they are ABD and their household income and assets do not exceed the Medicaid income and asset standards for the MN (e.g., $350 per month in income and $2,500 in assets for a household of one person). The allowed income and assets vary depending upon family size. (Coverage Groups 03 of COMAR 10.09.24.03) Individuals qualify through ABD spend-down, if they are ABD persons whose household assets meet the medically needy standards but whose household income exceeds the Medicaid income limit for the MN. The individual becomes Medicaid-eligible once incurred medical expenses total or exceed that excess amount. (COMAR 10.09.24.03)