[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: 42CFR435.138]



[Page 120-121]

 

                         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. 435.138  Disabled widows and widowers aged 60 through 64 who would 

be eligible for SSI except for early receipt of social security benefits.



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

individuals receiving SSI or State supplements, the



[[Page 121]]



agency must provide Medicaid to disabled widows and widowers who--

    (1) Are at least age 60;

    (2) Are not entitled to hospital insurance benefits under Medicare 

Part A; and

    (3) Become ineligible for SSI or a State supplement because of 

mandatory application (under section 1611(e)(2)) for and receipt of 

widow's or widower's social security disability benefits under section 

202(e) or (f) (or any other provision of section 202 if they are also 

eligible for benefits under subsections (e) or (f)) of the Act.

    For purposes of title XIX, individuals who meet these requirements 

are deemed to be title XVI payment recipients under section 1634(d) of 

the Act.

    (b) 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 a mandatory or 

optional State supplement. If the individual incurs enough medical 

expenses to reduce his or her income to the financial eligibility 

standard for the categorically needy under the State's more restrictive 

eligibility criteria, the agency must cover the individual as 

categorically needy. In determining the amount of his or her income, the 

agency may deduct all, part, or none of the amount of the social 

security disability benefits that made him or her ineligible for SSI or 

a State supplement, up to the amount that made him or her ineligible for 

SSI.

    (c) Individuals who may be eligible under this section must file a 

written application for Medicaid. Medicaid coverage may begin no earlier 

than July 1, 1988.

    (d) The agency must determine whether individuals may be eligible 

for Medicaid under this section.



[55 FR 48608, Nov. 21, 1990]



                  Mandatory Coverage of Certain Aliens