These optional groups share characteristics of the mandatory groups, but the eligibility criteria are somewhat more liberally defined. Eligibility for the medically needy program does not have to be as extensive as the categorically needy program. However, States which elect to include the medically needy under their plans are required to include certain children under age 18 and pregnant women who, except for income and resources, would be eligible as categorically needy. In 1995, there were 40 medically needy programs which provided at least some services to recipients. Amplification on Medicaid Eligibility Coverage may start retroactive to any or all of the 3 months prior to application, if the individual would have been eligible during the retroactive period.
Coverage generally stops at the end of the month in which a person's circumstances change.
No Federal funds are provided for State-only programs. Medicaid does not provide medical assistance for all poor persons. As noted earlier, categorically needy persons who are eligible for Medicaid may or may not also receive cash assistance from the TANF program or from the SSI program. Medically needy persons who would be categorically eligible except for income or assets may become eligible for Medicaid solely because of excessive medical expenses. For some groups, the more liberal income methodologies cannot result in the individual's income exceeding the limits prescribed for Federal matching.