2002 CFR Title 42, Volume 3

Title 42--Public Health CHAPTER IV--CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES PART 435--ELIGIBILITY IN THE STATES, DISTRICT OF COLUMBIA, THE NORTHERN MARIANA ISLANDS, AND AMERICAN SAMOA
	435.2	Purpose and applicability.
	435.3	Basis.
	435.4	Definitions and use of terms.
	435.10	State plan requirements.
	435.100	Scope.
	435.110	Individuals receiving aid to families with dependent children.
	435.112	Families terminated from AFDC because of increased earnings or hours of employment.
	435.113	Individuals who are ineligible for AFDC because of requirements that do not apply under title XIX of the Act.
	435.114	Individuals who would be eligible for AFDC except for increased OASDI income under Pub. L. 92-336 (July 1, 1972).
	435.115	Individuals deemed to be receiving AFDC.
	435.116	Qualified pregnant women and children who are not qualified family members.
	435.117	Newborn children.
	435.119	Qualified family members.
	435.120	Individuals receiving SSI.
	435.121	Individuals in States using more restrictive requirements for Medicaid than the SSI requirements.
	435.122	Individuals who are ineligible for SSI or optional State supplements because of requirements that do not apply under title XIX of the Act.
	435.130	Individuals receiving mandatory State supplements.
	435.131	Individuals eligible as essential spouses in December 1973.
	435.132	Institutionalized individuals who were eligible in December 1973.
	435.133	Blind and disabled individuals eligible in December 1973.
	435.134	Individuals who would be eligible except for the increase in OASDI benefits under Pub. L. 92-336 (July 1, 1972).
	435.135	Individuals who become ineligible for cash assistance as a result of OASDI cost-of-living increases received after April 1977.
	435.136	State agency implementation requirements for one-time notice and annual review system.
	435.137	Disabled widows and widowers who would be eligible for SSI except for the increase in disability benefits resulting from elimination of the reduction factor under Pub. L. 98-21.
	435.138	Disabled widows and widowers aged 60 through 64 who would be eligible for SSI except for early receipt of social security benefits.
	435.139	Coverage for certain aliens.
	435.145	Children for whom adoption assistance or foster care maintenance payments are made.
	435.170	Pregnant women eligible for extended coverage.
	435.200	Scope.
	435.201	Individuals included in optional groups.
	435.210	Individuals who meet the income and resource requirements of the cash assistance programs.
	435.211	Individuals who would be eligible for cash assistance if they were not in medical institutions.
	435.212	Individuals who would be ineligible if they were not enrolled in an MCO or PCCM.
	435.217	Individuals receiving home and community-based services.
	435.220	Individuals who would meet the income and resource requirements under AFDC if child care costs were paid from earnings.
	435.222	Individuals under age 21 who meet the income and resource requirements of AFDC.
	435.223	Individuals who would be eligible for AFDC if coverage under the State's AFDC plan were as broad as allowed under title IV-A.
	435.225	Individuals under age 19 who would be eligible for Medicaid if they were in a medical institution.
	435.227	Individuals under age 21 who are under State adoption assistance agreements.
	435.229	Optional targeted low-income children.
	435.230	Aged, blind, and disabled individuals in States that use more restrictive requirements for Medicaid than SSI requirements: Optional coverage.
	435.232	Individuals receiving only optional State supplements.
	435.234	Individuals receiving only optional State supplements in States using more restrictive eligibility requirements than SSI and certain States using SSI criteria.
	435.236	Individuals in institutions who are eligible under a special income level.
	435.300	Scope.
	435.301	General rules.
	435.308	Medically needy coverage of individuals under age 21.
	435.310	Medically needy coverage of specified relatives.
	435.320	Medically needy coverage of the aged in States that cover individuals receiving SSI.
	435.322	Medically needy coverage of the blind in States that cover individuals receiving SSI.
	435.324	Medically needy coverage of the disabled in States that cover individuals receiving SSI.
	435.326	Individuals who would be ineligible if they were not enrolled in an MCO or PCCM.
	435.330	Medically needy coverage of the aged, blind, and disabled in States using more restrictive eligibility requirements for Medicaid than those used under SSI.
	435.340	Protected medically needy coverage for blind and disabled individuals eligible in December 1973.
	435.350	Coverage for certain aliens.
	435.400	Scope.
	435.401	General rules.
	435.403	State residence.
	435.404	Applicant's choice of category.
	435.406	Citizenship and alienage.
	435.408	Categories of aliens who are permanently residing in the United States under color of law.
	435.500	Scope.
	435.510	Determination of dependency.
	435.520	Age requirements for the aged.
	435.522	Determination of age.
	435.530	Definition of blindness.
	435.531	Determinations of blindness.
	435.540	Definition of disability.
	435.541	Determinations of disability.
	435.600	Scope.
	435.601	Application of financial eligibility methodologies.
	435.602	Financial responsibility of relatives and other individuals.
	435.608	Applications for other benefits.
	435.610	Assignment of rights to benefits.
	435.622	Individuals in institutions who are eligible under a special income level.
	435.631	General requirements for determining income eligibility in States using more restrictive requirements for Medicaid than SSI.
	435.640	Protected Medicaid eligibility for individuals eligible in December 1973.
	435.700	Scope.
	435.725	Post-eligibility treatment of income of institutionalized individuals in SSI States: Application of patient income to the cost of care.
	435.726	Post-eligibility treatment of income of individuals receiving home and community-based services furnished under a waiver: Application of patient income to the cost of care.
	435.733	Post-eligibility treatment of income of institutionalized individuals in States using more restrictive requirements than SSI: Application of patient income to the cost of care.
	435.735	Post-eligibility treatment of income and resources of individuals receiving home and community-based services furnished under a waiver: Application of patient income to the cost of care.
	435.800	Scope.
	435.811	Medically needy income standard: General requirements.
	435.814	Medically needy income standard: State plan requirements.
	435.831	Income eligibility.
	435.832	Post-eligibility treatment of income of institutionalized individuals: Application of patient income to the cost of care.
	435.840	Medically needy resource standard: General requirements.
	435.843	Medically needy resource standard: State plan requirements.
	435.845	Medically needy resource eligibility.
	435.900	Scope.
	435.901	Consistency with objectives and statutes.
	435.902	Simplicity of administration.
	435.903	Adherence of local agencies to State plan requirements.
	435.904	Establishment of outstation locations to process applications for certain low-income eligibility groups.
	435.905	Availability of program information.
	435.906	Opportunity to apply.
	435.907	Written application.
	435.908	Assistance with application.
	435.909	Automatic entitlement to Medicaid following a determination of eligibility under other programs.
	435.910	Use of social security number.
	435.911	Timely determination of eligibility.
	435.912	Notice of agency's decision concerning eligibility.
	435.913	Case documentation.
	435.914	Effective date.
	435.916	Periodic redeterminations of Medicaid eligibility.
	435.919	Timely and adequate notice concerning adverse actions.
	435.920	Verification of SSNs.
	435.930	Furnishing Medicaid.
	435.940	Basis and scope.
	435.945	General requirements.
	435.948	Requesting information.
	435.952	Use of information.
	435.953	Identifying items of information to use.
	435.955	Additional requirements regarding information released by a Federal agency.
	435.960	Standardized formats for furnishing and obtaining information to verifying income and eligibility.
	435.965	Delay of effective date.
	435.1000	Scope.
	435.1001	FFP for administration.
	435.1002	FFP for services.
	435.1003	FFP for redeterminations.
	435.1004	Recipients overcoming certain conditions of eligibility.
	435.1005	Recipients in institutions eligible under a special income standard.
	435.1006	Recipients of optional State supplements only.
	435.1007	Categorically needy, medically needy, and qualified Medicare beneficiaries.
	435.1008	Institutionalized individuals.
	435.1009	Definitions relating to institutional status.
	435.1010	Requirement for mandatory State supplements.
	435.1011	Requirement for maintenance of optional State supplement expenditures.
	435.1100	Basis and scope.
	435.1101	Definitions related to presumptive eligibility for children.
	435.1102	General rules.