D.C. Mun. Regs. tit. 29, r. 29-1502

Current through Register Vol. 72, No. 2, January 10, 2025

Rule 29-1502 - ELIGIBILITY

1502.1

Participation in the demonstration program shall be limited to District residents who meet the following qualifications:

(a) Are between the ages of fifty (50) and sixty-four (64);

(b) Have a gross annual income that is at or below the medically needy limit, or fifty percent (50%) of the poverty federal poverty limit, whichever is higher;

(c) Have resources below the categorically-needy limits as noted in the State Plan (two thousand six hundred dollars ($ 2,600) for individuals and three thousand dollars ($ 3,000) for couples);

(d) Are not eligible for benefits under Title XIX or Title XXI of the Social Security Act, including "spend-down" Medicaid; and

(e) Do not reside in long-term care, mental health, or penal institutions.

1502.2

The IMA shall make no posthumous eligibility determinations.

1502.3

Persons who wish to receive benefits pursuant to this chapter shall submit an application for Medical Assistance to the Income Maintenance Administration or its designee.

1502.4

The District shall enroll demonstration program clients to Title XIX or Title XXI-funded Medicaid programs as they become eligible. The District will change eligibility status as appropriate and inform the affected beneficiaries in a timely manner. During the process of changing eligibility status there shall be no disruption in a recipient's enrollment in Medicaid or in the continuity of care for the recipient.

1502.5

The MAA shall redetermine eligibility annually following an enrollee's initial date of enrollment. The MAA may submit notices of redetermination to demonstration program enrollees and the case manager, if appropriate. Demonstration program enrollees shall have ninety (90) days to respond to notices of redetermination. The District may vary these provisions in extraordinary circumstances.

1502.6

Satisfaction of the eligibility requirements of this section shall not constitute an entitlement to receive benefits. Eligibility shall be determined according to the requirements of section 1503 when there are more applicants than the demonstration program allows.

D.C. Mun. Regs. tit. 29, r. 29-1502

Emergency Rulemaking published at 49 DCR 11457 (December 20, 2002) [EXPIRED]; as amended by Emergency Rulemaking published at 50 DCR 3876 (May 16, 2003) [EXPIRED]; as amended by Final Rulemaking published at 50 DCR 6183 (August 1, 2003)