Categorical Eligibility

Categorical Eligibility. A. Eligibility for the Medicaid program is limited to certain groups of individuals authorized by Congress. B. When authorizing a group, Congress also establishes specific requirements that must be met to qualify as a member of that group. 1. Each designated group is assigned a category of assistance. 2. The requirements that must be met to fit into a group or category are known as categorical requirements. 3. The Division of Medicaid is responsible for the following categories of assistance: aged, blind, disabled, children under age nineteen (19), pregnant women and parents and caretakers with dependent children. The Division of Medicaid also manages and has oversight responsibility for former foster children to age twenty-six (26).