Other Requirements

Code 080 – Blind (Not Blind) Disabled (Not Disabled) — Use this code if a blind applicant does not meet the definition of economic blindness or a blind recipient is denied because his vision has been restored. Also, enter if a disabled applicant does not meet the definition of total and permanent disability or a disabled recipient is no longer totally disabled. If recovery from the incapacity is accompanied by employment or increased earnings, use codes 060 or 061. Computer-printed reason to applicant or recipient: Blind – "You do not meet the agency's definition of economic blindness." Disabled – "You do not meet the agency's definition of total and permanent disability." Blind – "Usted no cumple con la definición de ceguedad económica de la agencia." Disabled – "Usted no cumple con la definición de incapacidad total y permanente de la agencia."

Code 081 – Not Enrolled in Medicare Part A — Use this code if the applicant is not enrolled for Medicare Part A benefits and therefore cannot qualify for Qualified Medicare Beneficiary (QMB) or the Qualified Disabled Working Individuals (QDWI) programs. Use the code to deny a QMB or QDWI case if the client becomes unenrolled in Medicare Part A. Computer-printed reason to applicant or recipient: "You do not have Medicare Part A benefits." "Usted no tiene los beneficios de la Parte A de Medicare."

Code 083 (Form H1000-A Only) – 30 Consecutive Days Requirement — Use this code if an applicant has been denied because he does not meet the 30 consecutive day requirement. Computer-printed reason to applicant: "You have not lived in a Medicaid-certified long-term care facility for 30 consecutive days." "Usted no tiene 30 días consecutivos de vivir en un establecimiento certificado por Medicaid para proveer atención de largo plazo."

Code 086 – Admitted to Institution — Use this code if an applicant or recipient has been denied because he is an inmate of or has been admitted to an institution. Computer-printed reason to applicant or recipient: "You have been admitted to an institution." "Usted fue admitido en una institución."

Code 087 – Age — Use this code if an application or active case is denied because evidence proves ineligibility on the basis of age. This code does not apply to disabled recipients transferred to aged assistance on becoming 65 years old. In these cases use code 122, Category Change. Computer-printed reason to applicant or recipient: "You do not meet the age requirement." "Usted no cumple con el requisito de edad."

Code 088 – Residence — Use this code if evidence proves applicant is ineligible on the basis of residence, or if a recipient is known to have moved out of the state or remained out of the state longer than the minimum time allowed. If a recipient has moved out of the state to obtain employment, support from relatives, or for other known reason, use the code for that reason, rather than code 088. If an applicant or recipient cannot be located, use code 095. Computer-printed reason to applicant or recipient: "You do not meet residence requirements for assistance." "Usted no cumple con los requisitos de residencia para asistencia."

Code 089 – Citizenship or Legal Entry — Use this code if an applicant or recipient is ineligible because he is not a citizen nor a noncitizen lawfully admitted for permanent residence in the United States nor residing in the United States under color of law. Computer-printed reason to applicant or recipient: "You do not meet legal United States entry or citizenship requirement for assistance." "Usted no cumple con el requisito para asistencia de entrada legal en los E.U., ni de naturalización."

Code 090 (Form H1000-A Only) – Prior Eligibility (Used for Simultaneous Open and Close Only) — Use this code if an applicant is either deceased or currently ineligible for assistance but was eligible for Medicaid coverage during a prior period. Computer-printed reason to applicant: "Medical assistance was granted during a prior period, but you are not eligible now for medical or financial assistance." "Consiguió asistencia médica durante un periodo anterior, pero ahora no califica para asistencia médica ni financiera."

Code 091 – Failure to Furnish Information — Use this code only when an applicant or recipient fails to execute and return the completed eligibility form. Computer-printed reason to applicant or recipient: "You failed to complete and return the necessary eligibility form." "No devolvió usted debidamente completada la forma necesaria para calificar."

Code 092 – Other Eligibility Requirement — Use this code if an application or active case is denied because applicant or recipient does not meet an eligibility requirement other than need not covered by codes 076-089. Computer-printed reason to applicant or recipient: "You do not meet eligibility requirements for assistance." "Usted no cumple con los requisitos para calificar para asistencia."

Code 136 – Failure to Provide Proof of U.S. Citizenship — Use this code if an application or active case is denied because applicant or recipient is a U.S citizen or national and fails to provide proof of U.S. citizenship. Computer-printed reason to applicant or recipient: “(Last, First) is not eligible for Medicaid because proof of U.S. citizenship was not provided. As soon as this information is provided, this person may be eligible for Medicaid.” “(Last name, first name) no llena los requisitos de Medicaid porque no presentó prueba de ciudadanía estadounidense. Una vez que esta persona presente la información, es posible que llene los requisitos de Medicaid.”