Iowa Administrative Code › Agency 441 - Human Services Department › Title VIII - Medical Assistance › Chapter 75 - Conditions of Eligibility › Rule 441-75.13 - Categorical Relatedness

Current through Register Vol. 47, No. 3, July 24, 2024
(1)
FMAP-related Medicaid eligibility.
Medicaid eligibility for
				persons who are under the age of 21, pregnant women, or specified relatives of
				dependent children who are not blind or disabled shall be determined using the
				income criteria in effect for the family medical assistance program (FMAP) as
				provided in subrule 75.1(14) unless otherwise specified. Income shall be
				considered prospectively.
(2)
SSI-related Medicaid.
Except as otherwise provided in
				441-Chapters 75 and 76, persons who are 65 years of age or older, blind, or
				disabled are eligible for Medicaid only if eligible for the Supplemental
				Security Income (SSI) program administered by the United States Social Security
				Administration.
a.
SSI policy
				reference.
The statutes, regulations, and policy governing eligibility
				for SSI are found in Title XVI of the Social Security Act ( 42 U.S.C. Sections
				1381 to 1383f), in the federal regulations promulgated pursuant to Title XVI (
				20
				CFR 416.101 to
				416.2227
				), and in Part 5 of the Program Operations Manual System published by the
				United States Social Security Administration. The Program Operations Manual
				System is available at Social Security Administration offices in Ames,
				Burlington, Carroll, Cedar Rapids, Clinton, Council Bluffs, Creston, Davenport,
				Decorah, Des Moines, Dubuque, Fort Dodge, Iowa City, Marshalltown, Mason City,
				Oskaloosa, Ottumwa, Sioux City, Spencer, Storm Lake, and Waterloo, or through
				the Department of Human Services, Division of Financial, Health, and Work
				Supports, Hoover State Office Building, 1305 East Walnut, Des Moines, Iowa
				50319-0114.
b.
Income
				considered.
For SSI-related Medicaid eligibility purposes, income
				shall be considered prospectively.
c.
Trust contributions.
Income that a person contributes to a trust as specified at 75.24(3)
"b
				"
shall not be considered for purposes of determining eligibility for
				SSI-related Medicaid.
d.
Conditional eligibility.
For purposes of determining
				eligibility for SSI-related Medicaid, the SSI conditional eligibility process,
				by which a client may receive SSI benefits while attempting to sell excess
				resources, found at
				20 CFR
				416.1240 to
				416.1245,
				is not considered an eligibility methodology.
e.
Valuation of life estates and
				remainder interests.
In the absence of other evidence, the value of a
				life estate or remainder interest in property shall be determined using the
				following table by multiplying the fair market value of the entire underlying
				property (including all life estates and all remainder interests) by the life
				estate or remainder interest decimal corresponding to the age of the life
				estate holder or other person whose life controls the life estate.
If a Medicaid applicant or recipient disputes the value
				  determined using the following table, the applicant or recipient may submit
				  other evidence and the value of the life estate or remainder interest shall be
				  determined based on the preponderance of all the evidence submitted to or
				  obtained by the department, including the value given by the following
				  table.
Age
Life Estate
Remainder
Age
Life Estate
Remainder
Age
Life Estate
Remainder
0
.97188
.02812
37
.93026
.06974
74
.53862
.46138
1
.98988
.01012
38
.92567
.07433
75
.52149
.47851
2
.99017
.00983
39
.92083
.07917
76
.51441
.49559
3
.99008
.00992
40
.91571
.08429
77
.48742
.51258
4
.98981
.01019
41
.91030
.08970
78
.47049
.52951
5
.98938
.01062
42
.90457
.09543
79
.45357
.54643
6
.98884
.01116
43
.89855
.10145
80
.43569
.56341
7
.98822
.01178
44
.89221
.10779
81
.41967
.58033
8
.98748
.01252
45
.88558
.11442
82
.40295
.59705
Age
Life Estate
Remainder
Age
Life Estate
Remainder
Age
Life Estate
Remainder
9
.98663
.01337
46
.87863
.12137
83
.38642
.61358
10
.98565
.01435
47
.87137
.12863
84
.36998
.63002
11
.98453
.01547
48
.86374
.13626
85
.35359
.64641
12
.98329
.01671
49
.85578
.14422
86
.33764
.66236
13
.98198
.01802
50
.84743
.15257
87
.32262
.67738
14
.98066
.01934
51
.83674
.16126
88
.30859
.69141
15
.97937
.02063
52
.82969
.17031
89
.29526
.70474
16
.97815
.02185
53
.82028
.17972
90
.28221
.71779
17
.97700
.02300
54
.81054
.18946
91
.26955
.73045
18
.97590
.02410
55
.80046
.19954
92
.25771
.74229
19
.97480
.02520
56
.79006
.20994
93
.24692
.75308
20
.97365
.02635
57
.77931
.22069
94
.23728
.76272
21
.97245
.02755
58
.76822
.23178
95
.22887
.77113
22
.97120
.02880
59
.75675
.24325
96
.22181
.77819
23
.96986
.03014
60
.74491
.25509
97
.21550
.78450
24
.96841
.03159
61
.73267
.26733
98
.21000
.79000
25
.96678
.03322
62
.72002
.27998
99
.20486
.79514
26
.96495
.03505
63
.70696
.29304
100
.19975
.80025
27
.96290
.03710
64
.69352
.30648
101
.19532
.80468
28
.96062
.03938
65
.67970
.32030
102
.19054
.80946
29
.95813
.04187
66
.66551
.33449
103
.18437
.81563
30
.95543
.04457
67
.65098
.343902
104
.17856
.82144
31
.95254
.04746
68
.63610
.363690
105
.16962
.83038
32
.94942
.05058
69
.62086
.37914
106
.15488
.84512
33
.94608
.05392
70
.60522
.39478
107
.13409
.86591
34
.94250
.05750
71
.58914
.41086
108
.10068
.89932
35
.93868
.06132
72
.57261
.42739
109
.04545
.95455
36
.93460
.06540
73
.55571
.44429