Arizona Administrative Code
Title 9 - HEALTH SERVICES
Chapter 22 - ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM - ADMINISTRATION
Article 15 - AHCCCS MEDICAL COVERAGE FOR PEOPLE WHO ARE AGED, BLIND, OR DISABLED
Section R9-22-1505 - Eligibility for Special Groups
Universal Citation: AZ Admin Code R 9-22-1505
Current through Register Vol. 30, No. 38, September 20, 2024
A. The following are considered special groups:
1. A person meeting the requirements in
A.R.S. §
36-2903.03
who:
a. Is aged, blind, or disabled under
42 CFR
435.520,
42 CFR
435.530, or
42 CFR
435.540 as of October 1, 2012, which are
incorporated by reference and on file with the Administration, and available
from the U.S. Government Printing Office, Mail Stop: IDCC, 732 N. Capitol
Street, NW, Washington, DC, 20401. This incorporation by reference contains no
future editions or amendments.
b.
Received SSI cash or AHCCCS medical coverage under this subsection, or
subsections (A)(2), (A)(3), or (A)(4) on or before August 21, 1996;
c. Was residing in the United States under
color of law on or before August 21, 1996; and
d. Meets the requirements under this
Article;
2. A disabled
child (DC) under
42 U.S.C.
1396 a(a)(10)(A)(i)(II). A disabled child is
a child who:
a. Was receiving SSI cash
benefits as a disabled child on August 22, 1996;
b. Lost SSI cash benefits effective July 1,
1997, or later, due to a disability determination under Section 211(d) of
Subtitle B of P.L.
104-193;
c. Continues to meet the disability
requirements for a child that were in effect on August 21, 1996; and
d. Meets the requirements under this
Article;
3. A disabled
adult child (DAC), under
42 U.S.C.
1383 c(c) who:
a. Was determined disabled by the Social
Security Administration before attaining the age of 22 years,
b. Became entitled to or received an increase
in child's insurance benefits under Title II of the Act on the basis of
blindness or disability,
c. Was
terminated from SSI cash benefits due to entitlement to or an increase in
income under Title II of the Act,
d. Meets the requirements under this Article,
and
e. Is 18 years of age or
older;
4. A disabled
widow or widower (DWW) under
42 U.S.C.
1383 c(b) and (d) who:
a. Is blind or disabled,
b. Is ineligible for Medicare Part A
benefits,
c. Received SSI cash
benefits the month before Title II of the Act benefit payments began,
d. Meets the requirements under this Article;
e. Is at least 50 years of age but
under age 65; and
f. Is
unmarried.
5. Under
42
CFR 435.135, a person who:
a. Is aged, blind, or disabled;
b. Receives benefits under Title II of the
Act;
c. Received SSI cash benefits
in the past;
d. Received SSI cash
benefits and Title II of the Social Security Act benefits concurrently for at
least one month anytime after April 1977;
e. Became ineligible for SSI cash benefits
while receiving SSI and benefits under Title II of the Act concurrently;
and
f. Meets the requirements under
this Article.
B. Income for special groups.
1. Except as provided in subsection (B)(2),
income eligibility is determined using the income criteria in
R9-22-1503.
2. Exceptions to income
for special groups.
a. For a person in the DAC
coverage group under subsection (A)(3), the applicant's Title II of the Social
Security Act benefits are disregarded in determining income eligibility under
42 U.S.C.
1383 c(c).
b. For a person in the DWW coverage group,
under subsection (A)(4), the applicant's Title II of the Social Security Act
benefits are disregarded in determining income eligibility under
42 U.S.C.
1383 c(b) and (d).
c. For an applicant or member in the coverage
group under subsection (A)(5), the portion of the applicant's or member's Title
II of the Social Security Act benefits attributed to cost-of-living adjustments
received by the applicant since the effective date of SSI ineligibility is
disregarded in determining income eligibility under
42
CFR 435.135.
C. 100 percent FBR. As a condition of eligibility for all special groups, countable income shall be equal to or less than 100 percent of the SSI FBR, as adjusted annually.
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