Section 16.03.05.785 - CERTAIN DISABLED CHILDRENA disabled child, not eligible for Medicaid outside a medical institution, is eligible for Medicaid if they meet the conditions below.
01.Age. Is under nineteen (19) years old.02.AABD Criteria. Meets the AABD blindness or disability criteria.03.AABD Resource Limit. Meets the AABD single person resource limit.04.Income Limit. Has monthly income not exceeding three (3) times the federal SSI benefit payable monthly to a single person.05.Eligible for Long-Term Care. Meets the medical conditions for long-term care in IDAPA 16.03.10, "Medicaid Enhanced Plan Benefits."06.Appropriate Care. Is appropriately cared for outside a medical institution, under a physician's plan of care.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.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 under IDAPA 16.03.18, "Medicaid Cost-Sharing."Idaho Admin. Code r. 16.03.05.785