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Manual Title Chapter Page Revision Date Virginia Medical Assistance Eligibility M02 October 2013 Subchapter Subject Page ending with Page M0210 NONFINANCIAL ELIGIBILITY REQUIREMENTS M0210.100 2

3. Example EXAMPLE: On January 5, 2006, Mr. H applies for Medicaid. He is in a nursing facility in Virginia, and has been there since July 5, 2005. When evaluating his application, the worker finds that he: • is a U.S. citizen, • is currently a Virginia resident residing in a medical institution in Virginia, • provided his SSN, • refused to provide third party liability and medical support information, • has applied for all benefits to which he is entitled, • meets the institutional status requirements, • is age 67 years and meets a covered group requirement. He currently has $5,000 in the bank. His income is $600 per month Social Security (SS). Since he refused to provide third party liability and medical support information, he does not meet the assignment of right requirements and his application must be denied. He is also informed of the resource limit and that he is ineligible for Medicaid because his resources exceed the limit.

M0210.100 INELIGIBLE PERSONS

A. Introduction The individuals listed in this section are not eligible for Medicaid. However, their income and resources may be considered in determining the eligibility of others in the household who have applied for Medicaid. B. Certain Recipients of General Relief (GR) A recipient of General Relief (GR) maintenance who does not meet a Medicaid covered group is not eligible for Medicaid. An applicant for Medicaid and Supplemental Security Income (SSI) who receives GR from the interim assistance component may become eligible for Medicaid following the establishment of SSI eligibility. Eligibility for an SSI payment is effective the month following the SSI application month. When the Medicaid application is dated in the same month as the SSI application, Medicaid eligibility can be effective the month of application if the applicant meets all Medicaid eligibility requirements and another covered group requirement in the application month. C. Essential Spouse of an ABD Individual An essential spouse of an aged, blind, or disabled person who does not himself/herself meet a covered group is not eligible for Medicaid. D. Individual Who Refuses to Assign Rights By signing the application for medical assistance, an applicant assigns his rights to third party payments. Should the individual for any reason subsequently refuse to assign rights to third-party payments or support for himself or anyone for whom he can legally assign rights, he is not eligible for Medicaid. Failure to assign rights for another person will not affect the eligibility of that other person.