0805.000.00  ELIGIBILITY

IM-78 June 28, 2002

MA applications are processed on an individual basis.  Before a Medical Assistance application is approved, determine if the claimant is eligible for other assistance providing a cash grant (GR, SAB, BP, SNC), in the current or proposed living arrangement(s).  If the claimant appears eligible for any of these programs, explore this eligibility first.  (Claimants may receive GR cash and MA concurrently.  See “MA/GR Dual Eligibility”.)

If the claimant is not eligible for one of the cash programs, take and backdate an MA application to the date of the GR, SAB, BP, or SNC application if the claimant is interested in MA.

If a claimant is under age 65 and working, explore MA-WD eligibility.

0805.005.00  DECEMBER 1973 ELIGIBILITY REQUIREMENTS

To be eligible for Medical Assistance, the claimant must meet the December, 1973 eligibility requirements for Old Age Assistance (OAA), Permanent and Total Disability (PTD), or Aid to the Blind (AB).  The determination of eligibility is always based on whichever eligibility factors in effect in December 1973 (for either OAA, PTD, or AB) best meets the situation of the claimant.  These eligibility factors are explained in manual Section 1000.000.00: December 1973 Eligibility Requirements.  If the claimant is ineligible on any one of these factors, explore eligibility under the special eligibility groups listed in Section 0800.000.05.  Reject the MA application if the claimant is also ineligible under Section 1619 and MA-WD requirements.

0805.010.00  MA/GR DUAL ELIGIBILITY

IM-83 July 2, 2003, IM-89 July 22, 2003

Effective February 1, 1992, claimants may receive a General Relief cash grant and unrestricted Title XIX Medicaid coverage by meeting the eligibility criteria for both the General Relief and Medical Assistance programs.  These persons are known as dually eligible.

Claimants must apply for both MA and GR and meet all eligibility criteria in order to be determined dually eligible.  Follow usual investigative procedures for both programs to establish eligibility.  Refer to IM-5/IMU5 Instructions for specific procedures.

Effective August 1, 2003, the maximum General Relief (GR) cash grant will be reduced to $0.00 per month for each eligible individual. Although grants are currently not being paid, continue to approve individuals who meet the eligibility requirements for both programs as MA-GR cases. Continue to enter “A”  as the level of care in IMU5 on these cases. This will allow the cases to be identified if funding for the cash grant is appropriated in the future.