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Manual Title Chapter Page Revision Date Virginia Medical Assistance Eligibility M02 April 2021 Subchapter Subject Page ending with Page M0280 INSTITUTIONAL STATUS REQUIREMENTS Appendix 1 1
Institutional Status Quick Reference Guide
Placement or living arrangement Full Benefit Inpatient Only Ineligible
IMDs
age 22-65, Medicaid open at time of admission Medicaid Remains Open
age 22-65, Medicaid not open at time of admission
X
under age 22 and receiving inpatient psychiatric
treatment X
age 65 and older X
conditional release X
ICF-ID – all ages X
Residential
medical section X
private group home with no more than 3 beds X
private residential
X
public residential
less than 16 beds
X
16 or more beds
X
educational or vocational Institution X
Correctional Facilities
adults
DOC
X
regional jails
X
local jails
X
juveniles (DJJ) in secure facilities
held for care, protection, best, interest X
on probation X
held for criminal activity
X
juvenile on probation placed in psychiatric
hospital or residential treatment center
X
juvenile not on probation ordered to treatment
in a psychiatric hospital/residential treatment facility
X
Adult arrested, but not held in corrections
in medical facility prior to correctional facility
placement X
in regional or local jail prior to medical facility
X
TDO
not in jail prior to hospitalization X
in jail prior to hospitalization
X
Individual out on bail/released on own recognizance X
Adult on probation, parole, conditional release, or furlough X