209 AID TO THE PERMANENTLY AND TOTALLY DISABLED (APTD) (MAM)

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To be eligible for medical assistance under the Aid to the Permanently and Totally Disabled (APTD) program, an individual must meet all the requirements below:

• ages of 18 through 64;

• meet the requirements in PART 300, NON-FINANCIAL CRITERIA;

• meet the financial requirements listed below;

• be physically or mentally disabled to the extent the individual cannot engage in a substantial gainful employment activity; and

• have a disability that is a condition of physical or mental disease, impairment, or limitation which is likely to result in death, or can be expected to last for a continuous period of not less than 48 months.

The Family Services Specialist (FSS) is responsible for determining if an individual meets the Substantial Gainful Activity (SGA) criteria. SGA applies to initial eligibility only. Individuals with earned income who are applying for APTD must have adjusted earned income, computed by subtracting allowable Impairment Related Work Expenses (IRWE) from gross earned income, of less than $1,550. If the net income exceeds $1,550, the application must be denied. See the Medical Assistance Manual (MAM) Section 603.01, Earned Income Disregard, for policy regarding IRWE’s.

The Disability Determination Unit (DDU) determines if an individual meets the medical criteria of disabled.

If an individual loses APTD eligibility due to earnings exceeding the SGA limit, the individual may be eligible for Medicaid for Employed Adults with Disabilities (MEAD). See the Medical Assistance Manual (MAM) PART 211, MEDICAID FOR EMPLOYED ADULTS WITH DISABILITIES (MEAD).

APTD MA Financial Requirements

Assistance Group

Age Limit

Income Limit

Resource Limit

Categorically-Needy APTD MA

through

Categorically-needy MA income limit. See PART 601, Table A, Income Limits.

Categorically-needy resource limit. See Section 407.01, Categorically Needy Medical Assistance.

Medically-Needy APTD MA

through

Medically-needy MA income limit. See PART 601, Table A, Income Limits.

Medically-needy resource limit. See Section 407.03, Medically Needy Medical Assistance.

References: He-W 806.69; He-W 842.03; RSA 167:3-j; RSA 167:6,VI; 20 CFR 404.1574(b); 20 CFR 404.1575(c); 20 CFR 404.1584(d); 20 CFR 416.974(b); 20 CFR 416.975(c); 20 CFR 416.976; 20 CFR 416.1112(c)(6); 42 CFR 435.4; 42 CFR 435.540; 42 CFR 435.541; 45 CFR 233.10(b)(2); 45 CFR 233.80; 42 USC 1382c

Editorial Revisions Made: 2/2024