Eligibility Online Manual

M1001B INPAT-PSYCH (Geriatric Hall at the State Hospital in Evanston)

Purpose: This section will assist in determining eligibility for INPAT-PSYCH (Geriatric Hall at the State Hospital in Evanston).

Current Policy Effective Date: November 1, 2015

Date Last Reviewed: November 12, 2015

Previous Policy: April 1, 2012


1. Applicants Must Meet Basic Eligibility

Refer to Section M600 for a description of all basic eligibility factors.

2. Applicants Must Be Age 65 Or Older

3. SSI Eligibles Do Not Need To Submit Application

If SSI is lost, an application will be required to redetermine eligibility.

4. Applicants Must Meet Income Requirements

Require the countable income to be within the maximum income standard per month. Refer to Medicaid Table 1A to see income standards. Refer to Section M901 to determine if income is countable.

Use only the applicant’s income when determining if income requirements are met.

5. Applicants Must Meet Resource Requirements

Require the countable resources to be within the maximum resource limit. Refer to Medicaid Table 7 to see resource standards. Refer to Section M801 to determine if resources are countable.

6. Clients Must Be Reviewed

Clients must be periodically reviewed every 12 months to determine continued eligibility. Refer to Section M1403 for information on reviewing eligibility.

A review is not required for SSI clients.

Clients must be reviewed for other Medicaid program eligibility before closing cases.

7. Clients May Lose Benefits

The case will close on the first day of the next month when any of the following occur:

    • Client does not complete review.

    • Client enters a public institution, excluding the Geriatric Hall at the State Hospital in Evanston.

    • Client dies.

    • Client determined no longer eligible.


Defining Group: Social Security Act § 1902(a)(10)(A)(ii)(xv)

Income: 42 CFR 435 Subpart K

Resources: 42 CFR 435 Subpart L

Clarifying Information:

Applicants Do Not Have to Meet Medical Necessity.

Applicants Do Not Have to Meet 30 Consecutive Days of Institutionalization Requirement.

Applicants Do Not Have to Make Patient Contributions.

Worker Responsibilities:

Closing Cases

1. Finalize eligibility and close benefits in WES when the the applicant is no longer eligible.

2. Allow 15-day closure notice when an adverse action has occurred