Certain Disabled Children

A disabled child, not eligible for Medicaid outside a medical institution, is eligible for Medicaid if they meet the conditions below. (7-1-24) 01. Age. Is under nineteen (19) years old. (7-1-24) 02. AABD Criteria. Meets the AABD blindness or disability criteria. (7-1-24) 03. AABD Resource Limit. Meets the AABD single person resource limit. (7-1-24) 04. Income Limit. Has monthly income not exceeding three (3) times the federal SSI benefit payable monthly to a single person. (7-1-24) 05. Eligible for Long-Term Care. Meets the medical conditions for long-term care in IDAPA 16.03.26, “Medicaid Plan Benefits.” (7-1-24) 06. Appropriate Care. Is appropriately cared for outside a medical institution, under a physician’s plan of care. (7-1-24) 07. Cost of Care. Can be cared for cost effectively outside a medical institution. The estimated cost of caring for the child must not exceed the cost of the child’s care in a hospital, nursing facility, or ICF/IID. (7-1-24) IDAHO ADMINISTRATIVE CODE IDAPA 16.03.05 – Eligibility for Aid to Department of Health and Welfare the Aged, Blind, & Disabled (AABD) Section 787 Page 59 08. Share of Cost. The financially responsible adult of a certain disabled child, who has family income above one hundred fifty percent (150%) of the federal poverty guidelines, is required to share in the cost of the child’s Medicaid benefits pursuant to the Idaho Medicaid State Plan and Section 56-2203, Idaho Code. (7-1-24) 786. (RESERVED)