210 R.I. Code R. 210-RICR-40-00-1.1

Current through December 3, 2024
Section 210-RICR-40-00-1.1 - Overview of this Chapter
A. This chapter establishes the Medicaid "Integrated Health Care Coverage (IHCC)" groups for elders, adults with disabilities, and certain individuals who qualify as medically needy (MN) due to high health care expenses. In addition, sections of this chapter set forth the basic tenets of the SSI methodology for determining Medicaid eligibility in general and, specifically, for those applicants and beneficiaries seeking coverage through an IHCC Community Medicaid eligibility pathway. The term Community Medicaid refers hereinafter to anyone applying for or renewing eligibility for non-LTSS Medicaid health coverage as MN or through a pathway for elders and adults with disabilities on the basis of Supplemental Security Income (SSI), an SSI-related characteristic (that is, age, blindness or disabling impairment), or special requirements related to a particular characteristic, condition or circumstances. Community Medicaid also encompasses Medicare beneficiaries seeking financial assistance through the State's Medicare Premium Payment Program (MPPP). Although all the IHCC groups for MN and elders and adults with disabilities are described in this chapter - both Community Medicaid and LTSS, there are separate sections, as indicated below, that provide more in-depth provisions related to IHCC groups, as follows:
1. The Sherlock Plan provides an eligibility pathway for adults with disabilities who are working. Although referenced in this section as one of the IHCC groups subject to the SSI methodology, the Sherlock Plan is covered in detail in a separate section (Medicaid Code of Administrative Rules, Sherlock Plan Regulations) along with other eligibility opportunities for persons with disabilities who are working.
2. An overview of the LTSS coverage groups subject to the SSI methodology is included in this chapter to show areas of overlap in the application process and determination of financial eligibility.
3. Children and families in the IHCC category who are eligible on the basis of their participation in other programs - e.g., children in foster care or SSI-eligible -- are addressed in the Medicaid Code of Administrative Rules, Medicaid Coverage for Children and Families.

210 R.I. Code R. 210-RICR-40-00-1.1