65A-1.710. SSI-Related Medicaid Coverage Groups  

Effective on Sunday, January 12, 2020
  • 1The Department covers all mandatory coverage groups and the following optional coverage groups:

    14(1) MEDS-AD Demonstration Waiver. A Medicaid coverage group for aged or disabled individuals (or couples), as provided in 3242 U.S.C. §1396a(m).

    35(2) Institutional Care Program (ICP). A Medicaid coverage group that helps pay for the cost of care in a nursing facility for institutionalized aged, blind or disabled individuals (or couples) who would be eligible for cash assistance except for their institutional status and income as provided in 8242 C.F.R. §§435.211 85and 435.236.

    87(3) Hospice Program. A Medicaid coverage group that provides care and support to individuals who are terminally ill and meets the specific Medicaid hospice eligibilty requirements as provided in 11642 U.S.C. §1396d(a). 119subsection 12065A-1.711(3) 121and Rule 12365A-1.713, 124F.A.C.

    125(4) Home and Community Based Services (HCBS). A Medicaid coverage group for aged, blind or disabled individuals that provides coverage for services and activities to prevent institutionalization and allow the individual to remain in the community. 161The approved HCBS Waivers as permitted by 16842 U.S.C. §1396n 171and 17242 C.F.R. §435.217 175are intended to prevent institutionalizing individuals who:

    182(a) Satisfy all SSI-Related Medicaid financial and non-financial eligibility criteria; and

    193(b) Have resources and income within Institutional Care or MEDS-AD Demonstration Waiver Program limits.

    207(5) Medically Needy Program. A Medicaid coverage group, as allowed by 21842 U.S.C. §§1396a 221and 1396d, for aged, blind or disabled individuals (or couples) whose countable income exceeds the applicable Medically Needy Income Level (MNIL) in subsection 24465A-1.716(2), 245F.A.C.

    246Rulemaking Authority 248409.919 FS. 250Law Implemented 252409.902, 253409.903, 254409.904, 255409.906, 256409.919 FS. 258History–New 10-8-97, Amended 1-27-99, 4-1-03, 6-13-04, 8-10-06 (4), (6), 8-10-06 (6), (7), (8), 10-9-13, 1-12-20.