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SSI Ineligibility - In Institution with Excess Income - Iowa

Medicaid is available to a person who meets all of the following requirements:

·     Receives care in a hospital, nursing facility, NF/MI, psychiatric medical institution or ICF/MR and has been institutionalized for 30 consecutive days.

·     Meets the level of care requirements for the institution, as determined by the Iowa Foundation for Medical Care or Medicare. (If you have access to the Internet and Adobe Acrobat, see Iowa Dept of Human Services Employees' Manual, Title 8, Chapter I, Medical Necessity.)

·     Either:

·     Is aged 18 or older and meets all Supplemental Security Income (SSI) eligibility requirements except income, or

·     Is under age 18 and meets all Supplemental Security Income (SSI) eligibility requirements except income and resources.

·     Has gross monthly income that is more than SSI standards but that does not exceed 300% of the federal SSI benefit for one which in the year 2004 is $1,692. If both spouses enter a medical institution and live in the same room, the income limit is two times the single rate.

For all persons in this coverage group, income is counted using SSI policies. For adults, resources are counted using SSI policies. For children under age 18, resources of all household members are disregarded.

See Also:

·           Overview of Medical Assistance in Iowa

·           Welcome and Introduction to Benefits in Iowa

Source: Iowa Dept of Human Services Employees’ Manual

Title 8 Medicaid

·                        Chapter F, Coverage Groups

Legal reference: 42 CFR 435.236, P.L. 100-360, 441 IAC 75.1(7), 75.5(4), 75.13(2)

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