Categorical and medical eligibility is covered in Chapter 2. Here we begin an aerial fly-over of financial eligibility. In this chapter we are painting with a broad brush. Subsequent chapters will examine financial eligibility and planning techniques in more detail.
In reviewing financial eligibility, it is important to know which class of assistance the applicant is seeking. Medicaid eligibility can be divided into three broad classes of assistance, each having it own financial criteria: (a) mandatory categorically needy; (b) optional categorically needy; and (c) medically needy. A State must allow an individual eligible for more than one class of assistance to have eligibility determined for the category he or she selects. 42 C.F.R. § 435.404.
Federal law defines Mandatory categorically needy at (42 U.S.C. § 1396a(A)(10)(A)(i)) and defines Optional categorically needy at (42 U.S.C. § 1396a(a)(10)(A)(ii)). At the State’s option, Medically Needy individuals may also be served. (42 U.S.C. § 1396a(a)(10)(C)). Mandatory coverage is also listed in 42 C.F.R. Part 435, Subpart B, § 435.100 through 435.172 (listing Mandatory Coverage).
A fundamental concept is that Medicaid law does not alter rights based on other laws. Medicaid evaluates those rights to determine whether they impact eligibility.
ADLs and IADLs Activities of Daily Living and Instrumental Activities of Daily Living describe basic…
Planning for Adult Children with Disabilities Childhood Disability Benefits assist disabled children and adults who…
Video Wills You might wonder whether you can make a video recording of yourself stating…
2025 Georgia Medicaid Transfer Penalty If an applicant for long-term care Medicaid (e.g., nursing home…
Recently, my dad died. While I was driving back from being sworn in as his…
In Georgia, an individual has legal capacity to make a Will "when the testator has…
