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Home and Community Based Services Manual

2.00 Appendix 3 Medical Eligibility (ME) Category Chart

Home and Community Based Services Manual


2.00 Appendix 3 Medical Eligibility (ME) Category Chart

Eligibility for:

MEDescriptionState PlanADWILWADCWSFCW
02Blind PensionYesNoNoNoNo
03Aid to the BlindYesYesYesYesYes
04Permanently and Totally DisabledYesYesYesYesYes
*05MO HealthNet for Families - AdultYesNoYesYesYes
*10Refugees other than Cuban, Haitian, Russian JYesNoNoNoNo
11MO HealthNet Old Age AssistanceYesYesYesYesYes
12MO HealthNet - Aid to the BlindYesYesYesYesYes
13MO HealthNet - Permanently and Totally DisabledYesYesYesYesYes
14Supplemental Nursing Care - Old Age AiYes**NoNoNoNo
15Supplemental Nursing Care - Aid to the BlindYes**NoNoNoNo
16Supplemental Nursing Care-Permanently and Totally DisabledYes**NoNoNoNo
*18MO HealthNet for Pregnant WomenYesNoYesYesYes
*19Cuban RefugeeYesNoNoNoNo
*21Haitian RefugeeYesNoNoNoNo
*24Russian JewYesNoNoNoNo
*26Ethiopian RefugeeYesNoNoNoNo
*36Adoption Subsidy – Federal Financial ParticipationYesNoNoNoNo
*37Title XIX - Homeless, Dependent, NeglectedYesNoYesYesYes
*38Independent Foster Care Children Ages 18-26YesNoYesYesYes
*43Pregnant Woman - 60 Day Assistance (MHN criteria)YesNoYesYesYes
*44Pregnant Woman - 60 Day Assistance-PovertyYesNoYesYesYes
*45Pregnant Woman - PovertyYesNoYesYesYes
55Qualified Medicare Beneficiary (QMB)NoNoNoNoNo
*56Adoption Subsidy – Title IV-EYesNoNoNoNo
*61MO HealthNet for Pregnant Women (HIF)YesNoYesYesYes
*73,7475Children Ages 0-18YesNoNoNoNo
82MoRx (Medicare Part D Wrap-Around Benefits)NoNoNoNoNo
83Breast or Cervical Cancer Control Project -PresumptiveYesNoNoNoNo
84Breast or Cervical Cancer Control Project - RegularYesYesYesYesYes
85Ticket to Work Health Assurance - PremiumYesYesYesYesYes
86Ticket to Work Health Assurance - Non-PiYesYesYesYesYes
91Gateway to Better HealthNoNoNoNoNo
***E2Adult Expansion Group (Medicaid Expansion)Yes***NoNoNoNo

 

* Participants enrolled in a Managed Care Health Plan are not eligible to receive services authorized by the Division of Senior and Disability Services (DSDS) and need to be directed to their health plan.

** PC in RCF/ALF authorizations only.

*** Participants with an ME code E2 are only eligible for Consumer-Directed Services authorized by DSDS.

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