Nebraska Administrative Code
Topic - HEALTH AND HUMAN SERVICES SYSTEM
Title 477 - MEDICAID ELIGIBILITY
Chapter 27 - ELIGIBILITY FOR THE AGED, BLIND, AND DISABLED; MEDICALLY NEEDY; QUALIFIED DISABLED WORKING INDIVIDUALS; MEDICAID INSURANCE FOR THE WORKERS WITH DISABILITIES; BREAST AND CERVICAL CANCER; EMERGENCY MEDICAL SERVICES ASSISTANCE; AND KATIE BECKETT
Section 477-27-007 - MEDICALLY NEEDY
Current through September 17, 2024
Parents or caretaker relatives, children, pregnant women, and aged, blind, or disabled (ABD) individuals with a medical need and high medical expenses whose income exceeds the guidelines for Medicaid eligibility in another eligibility category may be eligible as medically needy if all other eligibility requirements are met. A medically needy individual must incur and obligate a certain amount of medical expenses each month before Medicaid will provide coverage for the rest of the month. These medical expenses must be at least equal to the difference between the individual's income and the applicable income standard. The share of cost obligation varies depending on the individual's household size and income. Each month is determined separately and continuous eligibility does not apply. Individuals without a demonstrated medical need are not eligible under this category.
007.01 AGE. A medically needy child is eligible through age 18 years old if the child is a citizen or is a qualified non-citizen.
007.02 TWO-PARENT FAMILIES. If unmarried parents are living together and the father has acknowledged paternity for their child, eligibility must be considered for the family as a unit.
007.03 SHARE OF COST OBLIGATION. The share of cost (SOC) obligation for medically needy individuals is calculated in accordance with the provisions of 477 NAC 25.
