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.

Disclaimer: These regulations may not be the most recent version. Arizona may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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