us/regulation/42/435/603/h/1

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(1) Applicants and new enrollees. Financial eligibility for Medicaid for applicants, and other individuals not receiving Medicaid benefits at the point at which eligibility for Medicaid is being determined, must be based on current monthly household income and family size.

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regulations/42-cfr/435/603/h.yaml

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Rules

current_monthly_budget_period_required_for_applicant_or_new_enrollee

Derived

source: 42 CFR 435.603(h)

- name: current_monthly_budget_period_required_for_applicant_or_new_enrollee
  kind: derived
  entity: Person
  dtype: Judgment
  period: Month
  source: 42 CFR 435.603(h)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: condition
          source:
            corpus_citation_path: us/regulation/42/435/603/h
  versions:
    - effective_from: '2014-01-01'
      formula: |-
        individual_is_applicant_for_medicaid
        or individual_not_receiving_medicaid_benefits_when_eligibility_is_determined

current_beneficiary_current_monthly_budget_period_available

Derived

source: 42 CFR 435.603(h)(2)

- name: current_beneficiary_current_monthly_budget_period_available
  kind: derived
  entity: Person
  dtype: Judgment
  period: Month
  source: 42 CFR 435.603(h)(2)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: condition
          source:
            corpus_citation_path: us/regulation/42/435/603/h
  versions:
    - effective_from: '2014-01-01'
      formula: |-
        individual_is_current_medicaid_beneficiary
        and individual_determined_financially_eligible_using_magi_based_methods
        and state_plan_elects_current_monthly_household_income_and_family_size_budget_period

current_beneficiary_projected_annual_budget_period_available

Derived

source: 42 CFR 435.603(h)(2)

- name: current_beneficiary_projected_annual_budget_period_available
  kind: derived
  entity: Person
  dtype: Judgment
  period: Month
  source: 42 CFR 435.603(h)(2)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: condition
          source:
            corpus_citation_path: us/regulation/42/435/603/h
  versions:
    - effective_from: '2014-01-01'
      formula: >-
        individual_is_current_medicaid_beneficiary

        and individual_determined_financially_eligible_using_magi_based_methods

        and
        state_plan_elects_projected_annual_household_income_and_family_size_budget_period_for_remainder_of_current_calendar_year

reasonably_predictable_future_change_budget_adjustment_available

Derived

source: 42 CFR 435.603(h)(3)

- name: reasonably_predictable_future_change_budget_adjustment_available
  kind: derived
  entity: Person
  dtype: Judgment
  period: Month
  source: 42 CFR 435.603(h)(3)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: condition
          source:
            corpus_citation_path: us/regulation/42/435/603/h
  versions:
    - effective_from: '2014-01-01'
      formula: >-
        eligibility_determined_under_paragraph_h_1_or_h_2

        and agency_adopts_reasonable_prorated_future_change_method

        and (
          signed_employment_contract_evidences_future_change
          or clear_history_evidences_predictable_income_fluctuations
          or other_clear_indicia_evidence_future_income_or_family_size_change
        )

        and
        future_income_or_family_size_change_verified_under_income_and_eligibility_verification_requirements

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us/regulation/42/435/603/h/1 · Axiom

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regulations/42-cfr/435/603/h.yaml

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Rules

current_monthly_budget_period_required_for_applicant_or_new_enrollee

Derived

source: 42 CFR 435.603(h)

- name: current_monthly_budget_period_required_for_applicant_or_new_enrollee
  kind: derived
  entity: Person
  dtype: Judgment
  period: Month
  source: 42 CFR 435.603(h)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: condition
          source:
            corpus_citation_path: us/regulation/42/435/603/h
  versions:
    - effective_from: '2014-01-01'
      formula: |-
        individual_is_applicant_for_medicaid
        or individual_not_receiving_medicaid_benefits_when_eligibility_is_determined

current_beneficiary_current_monthly_budget_period_available

Derived

source: 42 CFR 435.603(h)(2)

- name: current_beneficiary_current_monthly_budget_period_available
  kind: derived
  entity: Person
  dtype: Judgment
  period: Month
  source: 42 CFR 435.603(h)(2)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: condition
          source:
            corpus_citation_path: us/regulation/42/435/603/h
  versions:
    - effective_from: '2014-01-01'
      formula: |-
        individual_is_current_medicaid_beneficiary
        and individual_determined_financially_eligible_using_magi_based_methods
        and state_plan_elects_current_monthly_household_income_and_family_size_budget_period

current_beneficiary_projected_annual_budget_period_available

Derived

source: 42 CFR 435.603(h)(2)

- name: current_beneficiary_projected_annual_budget_period_available
  kind: derived
  entity: Person
  dtype: Judgment
  period: Month
  source: 42 CFR 435.603(h)(2)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: condition
          source:
            corpus_citation_path: us/regulation/42/435/603/h
  versions:
    - effective_from: '2014-01-01'
      formula: >-
        individual_is_current_medicaid_beneficiary

        and individual_determined_financially_eligible_using_magi_based_methods

        and
        state_plan_elects_projected_annual_household_income_and_family_size_budget_period_for_remainder_of_current_calendar_year

reasonably_predictable_future_change_budget_adjustment_available

Derived

source: 42 CFR 435.603(h)(3)

- name: reasonably_predictable_future_change_budget_adjustment_available
  kind: derived
  entity: Person
  dtype: Judgment
  period: Month
  source: 42 CFR 435.603(h)(3)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: condition
          source:
            corpus_citation_path: us/regulation/42/435/603/h
  versions:
    - effective_from: '2014-01-01'
      formula: >-
        eligibility_determined_under_paragraph_h_1_or_h_2

        and agency_adopts_reasonable_prorated_future_change_method

        and (
          signed_employment_contract_evidences_future_change
          or clear_history_evidences_predictable_income_fluctuations
          or other_clear_indicia_evidence_future_income_or_family_size_change
        )

        and
        future_income_or_family_size_change_verified_under_income_and_eligibility_verification_requirements