[Code of Federal Regulations] [Title 42, Volume 3] [Revised as of October 1, 2004] From the U.S. Government Printing Office via GPO Access [CITE: 42CFR436.1] [Page 166-168] TITLE 42--PUBLIC HEALTH CHAPTER IV--CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) PART 436_ELIGIBILITY IN GUAM, PUERTO RICO, AND THE VIRGIN ISLANDS --Table of Contents Subpart A_General Provisions and Definitions Sec. 436.1 Purpose and applicability. Subpart A_General Provisions and Definitions Sec. 436.1 Purpose and applicability. 436.2 Basis. 436.3 Definitions and use of terms. 436.10 State plan requirements. Subpart B_Mandatory Coverage of the Categorically Needy 436.100 Scope. 436.110 Individuals receiving cash assistance. 436.111 Individuals who are not eligible for cash assistance because of a requirement not applicable under Medicaid. 436.112 Individuals who would be eligible for cash assistance except for increased OASDI under Pub. L. 92-336 (July 1, 1972). 436.114 Individuals deemed to be receiving AFDC. 436.116 Families terminated from AFDC because of increased earnings or hours of employment. 436.118 Children for whom adoption assistance or foster care maintenance payments are made. 436.120 Qualified pregnant women and children who are not qualified family members. 436.121 Qualified family members. 436.122 Pregnant women eligible for extended coverage. 436.124 Newborn children. 436.128 Coverage for certain qualified aliens. Subpart C_Options for Coverage as Categorically Needy 436.200 Scope. 436.201 Individuals included in optional groups. Options for Coverage of Families and Children and Aged, Blind, and Disabled Individuals, Including Pregnant Women 436.210 Individuals who meet the income and resource requirements of the cash assistance programs. 436.211 Individuals who would be eligible for cash assistance if they were not in medical institutions. 436.212 Individuals who would be eligible for cash assistance if the State plan for OAA, AFDC, AB, APTD, or AABD were as broad as allowed under the Act. 436.217 Individuals receiving home and community-based services. 436.220 Individuals who would meet the income and resource requirements under [[Page 167]] AFDC if child care costs were paid from earnings. 436.222 Individuals under age 21 who meet the income and resource requirements of AFDC. 436.224 Individuals under age 21 who are under State adoption assistance agreements. 436.229 Optional targeted low-income children. Options for Coverage of the Aged, Blind, and Disabled 436.230 Essential spouses of aged, blind, or disabled individuals receiving cash assistance. Subpart D_Optional Coverage of the Medically Needy 436.300 Scope. 436.301 General rules. 436.308 Medically needy coverage of individuals under age 21. 436.310 Medically needy coverage of specified relatives. 436.320 Medically needy coverage of the aged. 436.321 Medically needy coverage of the blind. 436.322 Medically needy coverage of the disabled. 436.330 Coverage for certain aliens. Subpart E_General Eligibility Requirements 436.400 Scope. 436.401 General rules. 436.402 [Reserved] 436.403 State residence. 436.404 Applicant's choice of category. 436.406 Citizenship and alienage. 436.408 Categories of aliens who are permanently residing in the United States under color of law. Subpart F_Categorical Requirements for Medicaid Eligibility 436.500 Scope. Dependency 436.510 Determination of dependency. Age 436.520 Age requirements for the aged. 436.522 Determination of age. Blindness 436.530 Definition of blindness. 436.531 Determination of blindness. Disability 436.540 Definition of disability. 436.541 Determination of disability. Subpart G_General Financial Eligibility Requirements and Options 436.600 Scope. 436.601 Application of financial eligibility methodologies. 436.602 Financial responsibility of relatives and other individuals. 436.604 [Reserved] 436.606 [Reserved] 436.608 Applications for other benefits. 436.610 Assignment of rights to benefits. Subpart H [Reserved] Subpart I_Financial Requirements for the Medically Needy 436.800 Scope. Medically Needy Income Standard 436.811 Medically needy income standard: General requirements. 436.814 Medically needy income standard: State plan requirements. Medically Needy Income Eligibility and Liability for Payment of Medical Expenses 436.831 Income eligibility. 436.832 Post-eligibility treatment of income of institutionalized individuals: Application of patient income to the cost of care. Medically Needy Resource Standard 436.840 Medically needy resource standard: General requirements. 436.843 Medically needy resource standard: State plan requirements. Determining Eligibility on the Basis of Resources 436.845 Medically needy resource eligibility. Subpart J_Eligibility in Guam, Puerto Rico, and the Virgin Islands 436.900 Scope. 436.901 General requirements. 436.909 Automatic entitlement to Medicaid following a determination of eligibility under other programs. Subpart K_Federal Financial Participation (FFP) 436.1000 Scope. FFP for Expenditures for Determining Eligibility and Providing Services 436.1001 FFP for administration. 436.1002 FFP for services. 436.1003 Recipients overcoming certain conditions of eligibility. 436.1004 Institutionalized individuals. [[Page 168]] 436.1005 Definitions relating to institutional status. Subpart L_Option for Coverage of Special Groups 436.1100 Basis and scope. Presumptive Eligibility for Children 436.1101 Definitions related to presumptive eligibility for children. 436.1102 General rules. Authority: Sec. 1102 of the Social Security Act (42 U.S.C. 1302). Source: 43 FR 45218, Sept. 29, 1978, unless otherwise noted. This part sets forth, for Guam, Puerto Rico, and the Virgin Islands-- (a) The eligibility provisions that a State plan must contain; (b) The mandatory and optional groups of individuals to whom Medicaid is provided under a State plan; (c) The eligibility requirements and procedures that a Medicaid agency must use in determining and redetermining eligibility, and requirements it may not use; and (d) The availability of FFP for providing Medicaid and for administering the eligibility provisions of the plan. [43 FR 45218, Sept. 29, 1978, as amended at 44 FR 17939, Mar. 23, 1979]