130 CMR, § 501.005

Current through Register 1533, October 25, 2024

Section 501.005 - Individuals and Families Eligible for or Receiving Medical Assistance on June 30, 1997

(A)Members Who Were Not Subject to a Deductible.

(1) Individuals and families (including caretaker relatives) who were receiving Medical Assistance on June 30, 1997, and whose family group gross income on June 30, 1997, exceeded MassHealth eligibility standards will be provided MassHealth Standard coverage for one year after the date of MassHealth implementation, except in the following circumstances:

(a) the individual or family no longer lives in Massachusetts;

(b) the individual enters an institution;

(c) the individual turns 65 years old;

(d) the individual or all members of the family are deceased; or

(e) the individual or family is no longer categorically eligible.

(2) Eligibility for continuing coverage will be reviewed toward the end of this one year period.

(B)Families Who Have Met a Deductible.

(1) Families (including caretaker relatives) with children younger than 18 years old who were receiving Medical Assistance on June 30, 1997, as a result of meeting a deductible, or who were denied with a deductible before July 1, 1997, and subsequently met a deductible on or after July 1, 1997, and whose family group gross income exceeds MassHealth standards will be eligible for MassHealth Standard for one year from the end of the deductible period, except in the following circumstances:

(a) the individual or family no longer lives in Massachusetts;

(b) the individual enters an institution;

(c) the individual turns 65 years old;

(d) the individual or all members of the family are deceased; or

(e) the individual or family is no longer categorically eligible.

(2) A determination of eligibility for MassHealth will be made toward the end of the one year period.

(C)Disabled Individuals Who Have Met a Deductible. Disabled individuals who were receiving Medical Assistance on June 30, 1997, as a result of meeting a deductible, or who meet a deductible on or after July 1, 1997, will have their continuing eligibility for MassHealth determined in accordance with 130 CMR 506.009: The One-time Deductible.