subchapter 21B – eligibility determination

SECTION .0100 – COVERAGE GROUPS

10A NCAC 21B .0101      MANDATORY (TRANSFERRED TO 10A nCAC 23D .0101)

10A ncac 21B .0102      OPTIONAL (TRANSFERRED TO 10A NCAC 23D .0102)

SECTION .0200 ‑ APPLICATION PROCESS

10A NCAC 21B .0201      ACCEPTANCE OF APPLICATION (TRANSFERRED TO 10A NCAC 23C .0101)

10A NCAC 21B .0202      face-to-face INTERVIEW (TRANSFERRED TO 10A NCAC 23C .0102)

10A NCAC 21B .0203      APPLICATION PROCESSING STANDARDS (TRANSFERRED TO 10A NCAC 23C .0201)

10A NCAC 21B .0204      EFFECTIVE DATE OF ASSISTANCE

(a)  The first month of Medicaid coverage shall be:

(1)           the month of application, or for SSI recipients, the month of application for SSI;

(2)           as much as three months prior to the month of application when the client received medical services covered by the program and was eligible during the month or months of medical need; or

(3)           if the client applies prior to meeting a non‑financial requirement, no earlier than the calendar month in which all non‑financial requirements are met.

(b)  Assistance shall be authorized beginning on the first day of the month except when:

(1)           the client's income exceeds the income level and he or she must spenddown the excess income for medical care. The assistance shall be authorized on the day his or her incurred medical care costs equal the amount of the excess income; or

(2)           otherwise stated in the Medicaid State Plan.

(c)  Medicaid coverage shall end on the last day of the last month of eligibility except for those individuals eligible for emergency conditions only as described in 10A NCAC 23E .0102. The last month of eligibility shall be the month in which the notice of termination period described in 10A NCAC 21A .0301 expires.

History Note:        Authority G.S. 108A‑54; 108A-54.1B; 42 C.F.R. 435.915;

Eff. September 1, 1984;

Amended Eff. January 1, 1995; October 1, 1991; August 1, 1990;

Temporary Amendment Eff. March 1, 2003;

Amended Eff. August 1, 2004;

Readopted Eff. July 1, 2018.

10A NCAC 21B .0205      RECOMMENDATION FOR DISPOSITION (TRANSFERRED TO 10A NCAC 23C .0103)

10A NCAC 21B .0206      DISPOSITION (TRANSFERRED TO 10A NCAC 23C .0104)

10A NCAC 21B .0207      REFERRALS at a face-to-face interview (TRANSFERRED TO 10A NCAC 23C .0105)

10A NCAC 21B .0208      MANDATORY USE OF OUTREACH LOCATIONS (TRANSFERRED TO 10A NCAC 23C .0106)

10A NCAC 21B .0209      hours for accepting financial and medical assistance applications (TRANSFERRED TO 10A ncac 23c .0107)

SECTION .0300 ‑ CONDITIONS FOR ELIGIBILITY

10A NCAC 21B .0301      AGE (TRANSFERRED TO 10A NCAC 23E .0101)

10A NCAC 21B .0302      UNITED STATES CITIZEN (TRANSFERRED TO 10A NCAC 23E .0102)

10A NCAC 21B .0303      RESIDENCE (TRANSFERRED TO 10A NCAC 23E .0103)

10A NCAC 21B .0304      DEPRIVATION (TRANSFERRED TO 10A NCAC 23E .0104)

10A NCAC 21B .0305      DISABILITY (TRANSFERRED TO 10A NCAC 23E .0105)

10A NCAC 21B .0306      BLINDNESS (TRANSFERRED TO 10A NCAC 23E .0106)

10A NCAC 21B .0307      CARETAKER RELATIVE (TRANSFERRED TO 10A nCAC 23E .0107)

10a NCAC 21B .0308      INMATE OF PUBLIC INSTITUTION OR PRIVATE PSYCHIATRIC HOSPITAL (TRANSFERRED TO 10A nCAC 23E .0108)

10A NCAC 21B .0309      APPLYING FOR ALL BENEFITS AND ANNUITIES (TRANSFERRED TO 10A NCAC 23E .0201)

10A NCAC 21B .0310      RESERVE (TRANSFERRED TO 10A NCAC 23E .0202)

10A NCAC 21B .0311      TRANSFER OF RESOURCES

History Note:        Authority G.S. 108A‑54; 108A‑58; P.L. 100‑360; P.L. 100‑485; 42 U.S.C. 1396p(c); 42 C.F.R. 435.121; 42 C.F.R. 435.840; 42 C.F.R. 435.841; 42 C.F.R. 435.845; S.L. 2002-126;

Eff. September 1, 1984;

Amended Eff. December 1, 1991; August 1, 1990;

Temporary Amendment Eff. April 21, 2003; March 1, 2003;

Amended Eff. August 1, 2004;

Repealed Eff. July 1, 2018.

10A NCAC 21B .0312      INCOME (TRANSFERRED TO 10A NCAC 23E .0203)

10A NCAC 21B .0313      PERSONAL NEEDS ALLOWANCE (TRANSFERRED TO 10A nCAC 23E .0204)

SECTION .0400 ‑ BUDGETING PRINCIPALS

10A NCAC 21B .0401      BUDGET UNIT MEMBERSHIP (TRANSFERRED TO 10A NCAC 23E .0205)

10A NCAC 21B .0402      FINANCIAL RESPONSIBILITY AND DEEMING (TRANSFERRED TO 10A NCAC 23E .0206)

10A NCAC 21B .0403      RESERVE (TRANSFERRED TO 10A NCAC 23E .0207)

10A NCAC 21B .0404      INCOME (TRANSFERRED TO 10A NCAC 23E .0208)

10A NCAC 21B .0405      CERTIFICATION AND AUTHORIZATION (TRANSFERRED TO 10A NCAC 23G .0101)

10A NCAC 21B .0406      DEDUCTIBLE (TRANSFERRED TO 10A NCAC 23E .0209)

10a NCAC 21B .0407      PATIENT LIABILITY (TRANSFERRED TO 10A NCAC 23E .0210)

10A NCAC 21B .0408      CLASSIFICATION (TRANSFERRED TO 10A NCAC 23D .0201)

10A NCAC 21B .0409      CHANGE IN SITUATION (TRANSFERRED TO 10A nCAC 23G .0304)

10A NCAC 21B .0410      ALIEN SPONSOR DEEMING (TRANSFERRED TO 10A NCAC 23E .0211)

SECTION .0500 ‑ REDETERMINATION

10A NCAC 21B .0501      TIME AND CONTENT (TRANSFERRED TO 10A NCAC 23G .0301)

10A NCAC 21B .0502      INTERVIEW (TRANSFERRED TO 10A NCAC 23G .0302)

10a NCAC 21B .0503      RECOMMENDATION (TRANSFERRED TO 10A NCAC 23G .0303)