265 MEDICALLY-NEEDY MEDICAL ASSISTANCE (MAM)

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Medically-needy medical assistance (MA) is a level of medical assistance provided to an individual who:

. meets the general, categorical, and technical requirements but not the financial requirements, for categorically-needy MA; and

. meets the financial requirements for medically-needy medical assistance.

Although there are some exceptions, in general, use the following when determining the financial eligibility of an individual for medically-needy medical assistance:

. the protected income level (PIL) when determining income eligibility for medically-needy medical assistance; and

. a special medically-needy resource limit.

Each program of assistance will specify its medically-needy financial requirements, and the different income or resource limits if applicable, if medically-needy medical assistance is offered.

In and Out MA is a type of medically-needy MA. This category of assistance is offered when an individual's countable income exceeds the medically-needy MA income limit. See PART 625, IN AND OUT MEDICAL ASSISTANCE, for more information.

Not every category of categorically-needy MA offers a corresponding medically-needy MA category. Medically-Needy MA or In and Out MA is not offered for:

. Medicaid for Employed Adults with Disabilities (MEAD);

. the Medicare Savings Programs (MSP) [Qualified Medicare Beneficiary (QMB), Specified Low Income Medicare Beneficiary (SLMB & SLMB135), and Qualified Disabled and Working Individual (QDWI) programs];

. Former Foster Care Child MA;

. Family Planning MA; or

. Granite Advantage Health Care Program (Granite Advantage).

References: He-W 601.05(l), He-W 601.06(s), He-W 602.04, He-W 606.89, He-W 656.06(d), He-W 658.04, He-W 678.01, He-W 680.01, He-W 682.01, RSA 167:6,VII, 42 CFR 435.301, Section 1902(a)(10) & (f) of the Social Security Act [42 USC 1396a(a)(10) & (f)]