Arkansas Administrative Code › Agency 016 - DEPARTMENT OF HUMAN SERVICES › Division 20 - Division of County Operations › Rule 016.20.98-029 - MS 98-5: SOBRA Medicaid Coverage of Pregnant Woman, Infants and Children - Revised Policy - Expand Medicaid coverage to children born after September 30, 1982, and before October 1, 1983, whose family income is at or below 100% of the Federal Poverty Level.

Current through Register Vol. 49, No. 6, June, 2024
2000
Individuals Eligible
			 for Medicaid
The following categories of Individuals are eligible for
				Medicaid:
1.
Individuals
			 eligible for Supplemental Security Income (SSI) benefits (i.e., recipients of
			 straight SSI benefits, mandatory state supplements, SSI conditional payments
			 and SSI presumptive disability payments). Re. MS 2010;
2.
Blind or disabled individuals with
			 converted cases who are not considered to be blind or disabled under SSI
			 criteria. Re. MS 2020;
3.
Individuals eligible for Medicaid as essential spouses in December 1973
			 and who continue to meet that eligibility criteria. Re. MS
			 2025;
4.
Medical Only
			 Individuals who are current recipients of SSA; who were previously eligible for
			 and received SSA and SSI concurrently in at least one month after April 1977;
			 and who would now be eligible for SSI if all COLA increases received since they
			 last received SSA and SSI concurrently were deducted from current income. Re.
			 MS 2030;
5.
Medical
			 Only Individuals whose assistance payments were terminated due to the 20%
			 increase in Social Security benefits in September 1972, and who would be
			 currently eligible for assistance payments if the 20% increase in Social
			 Security benefits in September 1972 were disregarded. Re. MS
			 2040;
6.
Disabled
			 widows and widowers who were entitled to SSA for December 1983; who received
			 SSA disability for January 1984; who lost SSI after January 1984, due to
			 elimination of a benefit reduction factor previously applied; who would be SSI
			 eligible if the 1984 reduction factor increase and all COLA's since 1984 were
			 disregarded; and who applied and were found eligible for Medicaid benefits
			 between July 1, 1986, and June 30, 1988. Re. MS 2045;
7.
Disabled widows and widowers who
			 were at least age 60 on or after 4/1/88, were not yet age 65 on 4/1/88,
			 formerly received SSI benefits which were terminated due to entitlement to SSA
			 widow's or widower's benefits, currently receive SSA widow's or widower's
			 benefits, are not currently eligible for Medicare, would be eligible for SSI if
			 ALL SSA benefits were disregarded, and are otherwise income and resource
			 eligible for Medicaid. Re. MS 2046;
8.
Disabled widows, widowers and
			 disabled surviving divorced spouses who lost their SSI due to receipt of SSA
			 benefits based on a less restrictive definition of disability that was used
			 prior to OBRA of 1990. Re. MS 2049;
9.
Qualified Medicare Beneficiaries who
			 qualify under the Medicare Catastrophic Coverage Act of 1988, and whose
			 benefits are limited to Medicare cost-sharing. Re. MS 2047;
10.
Specified Low Income Medicare
			 Beneficiaries whose income is between 100% and 120% of the Federal Poverty
			 Level and who meet all other requirements for the Category will be eligible for
			 payment of their Medicare Part B Premium. Re. MS 2051;
11.
Qualified Disabled and Working
			 Individuals who lost Medicare Part A entitlement solely due to Substantial
			 Gainful Activity. Medicaid coverage for these individuals is limited to payment
			 of their Part A premium. Re. MS 2048;
12.
Disabled Adult Children (DAC) who
			 are age 18 or older, who became disabled or blind before age 22, who were
			 receiving SSI based on disability or blindness, and who lost SSI on or after
			 July 1, 1987 due to a DAC entitlement or a DAC increase. Re. MS
			 2050;
13.
Individuals
			 who were eligible for Medicaid in Title XIX institutions in December 1973. Re.
			 MS 2044.3;
14.
Families who lose TEA related Medicaid eligibility due to increased wages
			 and who qualify for up to 12 months of transitional Medicaid. Re. MS
			 2061;
15.
Families who
			 lose TEA related Medicaid eligibility due to collection of child support
			 payments and who qualify for up to 3 months of extended Medicaid. Re. MS
			 2063;
16.
Eligible
			 individuals under age 21 and individuals age 65 and older who are receiving
			 inpatient psychiatric care in the Arkansas State Hospital or the George W.
			 Jackson Center. Re. MS 2070.
17.
Developmentally Disabled
			 Individuals who qualify for Home and Community Based Services. Re. MS
			 2075;
18.
Aged
			 Individuals who qualify for Home and Community Based Waiver Services. Re. MS
			 2076;
19.
Newborn
			 infants born to women determined to be Medicaid eligible when the infant was
			 born. Re. MS 2080;
20.
Individuals who qualify for services under the Alternatives for Adults
			 with Physical Disabilities Waiver. Re. MS 2078;
21.
Disabled children eligible for
			 Medicaid under TEFRA. Re. MS 2090;
22.
Illegal aliens who are eligible for
			 emergency services only. Re. MS 2095;
23.
Individuals who qualify for
			 retroactive Medicaid eligibility. Re. MS 2100 (applies to all categories except
			 Newborn Infants, PW-PE, QMB, SMB. QDWI, and Waiver Categories. Re. MS 2080, MS
			 5600, MS 2047, MS 2051, 2048, 2075, and 2076);
24.
Individuals in Title XIX Long Term
			 Care facilities who are eligible according to LTC criteria. Re. MS
			 3000;
25.
Women
			 eligible as Pregnant Women who meet the AFDC or Medically Needy standards of
			 need. Re. MS 5000, 7000;
*
			 26.
Pregnant women, infants and children (up to
			 age 6) whose Income does not exceed 133 percent of the Federal Poverty Level,
			 and children ages 6 and * older, who were born after September 30, 1982, whose
			 family income does not exceed 100 percent of the Federal Poverty Level. Re. MS
			 5600;
If a hearing is not requested during the advance notice
				period, the planned termination will be completed. If a hearing is requested
				during the advance notice period, the County Office will forward a copy of the
				DCO-700 (if applicable) along with the DCO-1200 to Appeals and Hearings and
				delay action pending the hearing.