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AGED, BLIND, AND DISABLED MEDICAID 008 Table of Standards-Categorically Needy Income

Supersedes: ABD 008 (01/01/2025)

Reference: 20 CFR 416.410,.412; 42 CFR 435.601(b), (d)(2); ARM 37.82.101 Overview: Effective January 1, 2026, use the following standards to determine resource and income eligibility for categorically needy coverage. INCOME STANDARDS: Individual living in the community.................................. $994

Couple living in the community.......................................$1491

Individual living in an institution..................................... $30

The Categorically Needy Income Standards are the beneﬁt amounts paid by the Social Security Administration to Supplemental Security Income (SSI) cash recipients. Applicants with monthly countable income equal to or less than these income standards are categorically needy Medicaid eligible. This means that they are considered qualiﬁed for SSI money payments if they choose to apply. Categorically Needy Medicaid recipients are eligible for Medicaid without a spend down, even though their income is actually higher than the medically needy income standard.

Applicants with monthly countable income in excess of these income standards are not categorically needy eligible. However, these applicants may be eligible for medically needy coverage.

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Official source

AGED, BLIND, AND DISABLED MEDICAID 008 Table of Standards-Categorically Needy Income

Supersedes: ABD 008 (01/01/2025)

Reference: 20 CFR 416.410,.412; 42 CFR 435.601(b), (d)(2); ARM 37.82.101 Overview: Effective January 1, 2026, use the following standards to determine resource and income eligibility for categorically needy coverage. INCOME STANDARDS: Individual living in the community.................................. $994

Couple living in the community.......................................$1491

Individual living in an institution..................................... $30

The Categorically Needy Income Standards are the beneﬁt amounts paid by the Social Security Administration to Supplemental Security Income (SSI) cash recipients. Applicants with monthly countable income equal to or less than these income standards are categorically needy Medicaid eligible. This means that they are considered qualiﬁed for SSI money payments if they choose to apply. Categorically Needy Medicaid recipients are eligible for Medicaid without a spend down, even though their income is actually higher than the medically needy income standard.

Applicants with monthly countable income in excess of these income standards are not categorically needy eligible. However, these applicants may be eligible for medically needy coverage.