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North Carolina Department of Health and Human Services Division of Medical Assistance Medicaid Eligibility Unit AGED, BLIND AND DISABLED MEDICAID MANUAL MA-2000

NON-SSI ELIGIBILITY REGULATIONS

1 MA-2000 NON-SSI ELIGIBILITY REGULATIONS REVISED 08/01/13 – CHANGE NO. 05-13

I. INTRODUCTION TO NON-SSI MEDICAID ELIGIBILITY DETERMINED BY DSS

In addition to Medicaid for SSI beneficiaries, North Carolina provides Medicaid to needy aged, blind, and disabled individuals who do not receive SSI. For these individuals, eligibility is determined by the county department of social services. Each individual must meet categorical, financial, and non-financial requirements of an aid/program category in order to be eligible for Medicaid.

Use the 2000 Series to determine Medicaid eligibility for all non-SSI beneficiaries.

The purpose of this section is to list the categorical, financial, and non-financial Medicaid requirements for aged, blind, and disabled individuals who do not receive SSI, and to provide a brief overview of the individuals covered under adult Medicaid by classification.

II. CATEGORICAL REQUIREMENTS FOR NON-SSI MEDICAID COVERAGE GROUPS

A. MAA

To receive under MAA the individual must be aged 65 or older.

B. MAB

To receive under MAB the individual must be legally blind according to the SSI definition of disability. Blindness is defined as central visual acuity of 20/200 or less in the better eye with the use of a correcting lens or a limitation in the field of vision of the better eye that meets certain criteria. (Also evaluate for HCWD. See MA 2180.)

C. MAD

To receive under MAD an individual must:

1. Be disabled according to the SSI definition of disability. The SSI definition of disability is: A physical or mental impairment which prevents an individual from engaging in any substantial gainful activity (or for a child under 18, an impairment of comparable severity) and which has lasted or is expected to last for at least 12 months or is expected to result in death. (For HCWD, substantial gainful activity is not a consideration. See MA 2180.)