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Manual Title Chapter Page Revision Date Virginia Medical Assistance Eligibility M03 October 2016 Subchapter Subject Page ending with Page M0320.000 AGED, BLIND & DISABLED GROUPS M0320.702 55

D. Enrollment

Eligible individuals in this group are classified as medically needy (MN). If the individual has Medicare Part A, compare the individual’s countable income to the QMB and SLMB limits. The following ACs are used when the individual is ABD MN and QMB or SLMB: • 028 for an aged individual also QMB; • 048 for a blind individual also QMB; • 068 for a disabled individual also QMB; • 024 for an aged MN individual also SLMB; • 044 for a blind or disabled MN individual also SLMB. The following ACs are used when the individual is ABD MN and not QMB or SLMB: • 018 for an aged individual NOT QMB or SLMB; • 038 for a blind individual NOT QMB or SLMB; • 058 for a disabled individual NOT QMB or SLMB. D. Referral to Health Insurance Marketplace When an ABD who does not have Medicare is placed on a spenddown, the individual must be referred to the Health Insurance Marketplace (HIM) so that the applicant’s eligibility for the APTC can be determined. Individuals with Medicare are not referred to the HIM.

M0320.702 DECEMBER 1973 ELIGIBLES

A. Policy 42 CFR 435.340 - If the State Plan covers the medically needy, the Plan must provide protected medically needy coverage for blind and disabled individuals eligible in December 1973. B. Blind or Disabled in December 1973 This is an MN covered group of blind and disabled individuals who: • were eligible as medically needy under the state plan in December 1973 on the basis of the blindness or disability criteria of the AB or APTD plan; • for each consecutive month after December 1973 continue to meet the December 1973 blindness or disability criteria and the December 1973 financial eligibility requirements; and • meet the current medically needy eligibility requirements except the blindness or disability criteria. Continuing eligibility is determined on the basis of eligibility requirements in effect as of December, 1973 and current medically needy requirements. Contact your Regional Medical Assistance Program Consultant if you have an applicant you believe meets this covered group.