[Code of Federal Regulations]

[Title 42, Volume 3]

[Revised as of October 1, 2005]

From the U.S. Government Printing Office via GPO Access

[CITE: 42CFR435.135]



[Page 119]

 

                         TITLE 42--PUBLIC HEALTH

 

  CHAPTER IV--CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF 

                  HEALTH AND HUMAN SERVICES (CONTINUED)

 

PART 435_ELIGIBILITY IN THE STATES, DISTRICT OF COLUMBIA, THE NORTHERN 

MARIANA ISLANDS, AND AMERICAN SAMOA--Table of Contents

 

         Subpart B_Mandatory Coverage of the Categorically Needy

 

Sec. 435.135  Individuals who become ineligible for cash assistance as 

a result of OASDI cost-of-living increases received after April 1977.



    (a) If an agency provides Medicaid to aged, blind, or disabled 

individuals receiving SSI or State supplements, it must provide Medicaid 

to individuals who--

    (1) Are receiving OASDI;

    (2) Were eligible for and receiving SSI or State supplements but 

became ineligible for those payments after April 1977; and

    (3) Would still be eligible for SSI or State supplements if the 

amount of OASDI cost-of-living increases paid under section 215(i) of 

the Act, after the last month after April 1977 for which those 

individuals were both eligible for and received SSI or a State 

supplement and were entitled to OASDI, were deducted from current OASDI 

benefits.

    (b) Cost-of-living increases include the increases received by the 

individual or his or her financially responsible spouse or other family 

member (e.g., a parent).

    (c) If the agency adopts more restrictive eligibility requirements 

than those under SSI, it must provide Medicaid to individuals specified 

in paragraph (a) of this section on the same basis as Medicaid is 

provided to individuals continuing to receive SSI or State supplements. 

If the individual incurs enough medical expenses to reduce his or her 

income to the financial eligibility standard for the categorically 

needy, the agency must cover that individual as categorically needy. In 

determining the amount of his or her income, the agency may deduct the 

cost-of-living increases paid under section 215(i) after the last month 

after April 1977 for which that individual was both eligible for and 

received SSI or a State supplement and was entitled to OASDI, up to the 

amount that made him or her ineligible for SSI.



[51 FR 12330, Apr. 10, 1986]