Page 7

MISSISSIPPI DIVISION OF MEDICAID Eligibility Policy and Procedures Manual CHAPTER 101 – Coverage Groups and Processing Applications and Reviews Page |101 Effective Month: December 2016 101.02 COVERAGE OF THE CATEGORICALLY NEEDY IN

MISSISSIPPI Medicaid programs in each state must provide coverage to specified categories of needy individuals that include: • Children, • Pregnant women, • Parents or caretaker relatives of dependent children, • Aged individuals and • Disabled or blind individuals.

Within these broad categories of coverage, the specific groups covered are either: • Mandatory – meaning federal law required coverage of the category, or • Optional – meaning federal law allows coverage of the category and state law authorizes the coverage.

Coverage for children, pregnant women and parents and caretaker relatives are referred to as MAGI-related coverage due to the application of Modified Adjusted Gross Income (MAGI) standards to these groups. MAGI standards are financial methodologies used to determine eligibility. Income standards for MAGI-related coverage are referred to as MAGI-equivalent standards. Effective January 1, 2014, federal law referred to as the Affordable Care Act or ACA required that net income thresholds in effect prior to the ACA be converted to equivalent MAGI levels to account for income disregards eliminated by the ACA. Coverage of the aged, blind and disabled are referred to as ABD coverage. ABD policy is based on the most closely related cash assistance program, which is the Supplemental Security Income (SSI) program. The ABD program area uses SSI policy rules except in categories that have been allowed to use more liberal methodologies through State Plan approval or in instances where Medicaid regulations implement Medicaid policy that takes precedence over SSI policy. Refer to the Categories of Eligibility (COE) Chart in the Appendix page by the same name for COE designations, sources of eligibility and other identifying information that is pertinent to each group.