C.F.R. » Title 42 » CHAPTER IV—CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES › SUBCHAPTER C—MEDICAL ASSISTANCE PROGRAMS › PART 435—ELIGIBILITY IN THE STATES, DISTRICT OF COLUMBIA, THE NORTHERN MARIANA ISLANDS, AND AMERICAN SAMOA › Subpart C—Options for Coverage

42 C.F.R. § 435.210

Optional eligibility for individuals who meet the income and resource requirements of the cash assistance programs

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(a) Basis. This section implements section 1902(a)(10)(A)(ii)(I) of the Act.

(b) Eligibility. The agency may provide Medicaid to any group or groups of individuals specified in § 435.201(a)(1) through (3) who meet the income and resource requirements of SSI or an optional State supplement program in States that provide Medicaid to optional State supplement recipients.

[81 FR 86452, Nov. 30, 2016]
Notes of Decisions
Cited in 5 cases, 1980–1989 · leading case: Herweg v. Ray, 455 U.S. 265 (1983).
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Herweg v. Ray, 455 U.S. 265 (1983). · cites it 2× “42 CFR § 435.210 (1980). [6] Petitioners' challenge was based both on statutory and constitutional grounds.”
Lewis v. Gross, 663 F. Supp. 1164 (E.D.N.Y. 1986). “The House Conference Report accompanying this provision noted that its purpose was to “make explicit current law related to coverage of the optional categorically needy, as reflected in current regulation at 42 C.F.R. §§ 435.210 et seq.” House Conference Report No.”
Peggy Armstrong Russell Hansen Yvonne Hansen v. Charles Palmer, 879 F.2d 437 (8th Cir. 1989). · cites it 3× “When applied to a Medicaid claimant whom the SSA has already found ineligible for SSI benefits, these regulations appear inconsistent.”
Herweg v. Ray, 619 F.2d 1265 (8th Cir. 1980). “This “gap” in the SSI— Medicaid scheme was remedied by providing that a state may provide Medicaid coverage to optional groups, including (1) those who are SSI eligible but do not receive benefits, 42 C.F.R. § 435.210 ; (2) those who are ineligible for SSI because of lower…”
Stilger v. Adult & Fam. Servs. Div., 749 P.2d 1204 (Or. Ct. App. 1988). “42 USC § 1396a(10)(A)(II)(IV) (“who are eligible * * * to have paid with respect to them * * * [SSI]”); 42 CFR § 435.210 (“would be eligible for * * * SSI * * * but who are not receiving these benefits”).”
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