Section 441.75.13. Categorical relatedness.

         75.13(1) FMAP-related Medicaid eligibility. Medicaid eligibility for persons who are under the age of 21, pregnant women, or specified relatives of dependent children who are not blind or disabled shall be determined using the income criteria in effect for the family medical assistance program (FMAP) as provided in subrule 75.1(14) unless otherwise specified. Income shall be considered prospectively.

         75.13(2) SSI-related Medicaid. Except as otherwise provided in 441—Chapters 75 and 76, persons who are 65 years of age or older, blind, or disabled are eligible for Medicaid only if eligible for the Supplemental Security Income (SSI) program administered by the United States Social Security Administration.

            a.                SSI policy reference. The statutes, regulations, and policy governing eligibility for SSI are found in Title XVI of the Social Security Act (42 U.S.C. Sections 1381 to 1383f), in the federal regulations promulgated pursuant to Title XVI (20 CFR 416.101 to 416.2227), and in Part 5 of the Program Operations Manual System published by the United States Social Security Administration. The Program Operations Manual System is available at Social Security Administration offices in Ames, Burlington, Carroll, Cedar Rapids, Clinton, Council Bluffs, Creston, Davenport, Decorah, Des Moines, Dubuque, Fort Dodge, Iowa City, Marshalltown, Mason City, Oskaloosa, Ottumwa, Sioux City, Spencer, Storm Lake, and Waterloo, or through the Department of Human Services, Division of Financial, Health, and Work Supports, Hoover State Office Building, 1305 East Walnut, Des Moines, Iowa 50319-0114.

            b.                Income considered. For SSI-related Medicaid eligibility purposes, income shall be considered prospectively.

            c.                Trust contributions. Income that a person contributes to a trust as specified at 75.24(3)“b” shall not be considered for purposes of determining eligibility for SSI-related Medicaid.

            d.                Conditional eligibility. For purposes of determining eligibility for SSI-related Medicaid, the SSI conditional eligibility process, by which a client may receive SSI benefits while attempting to sell excess resources, found at 20 CFR 416.1240 to 416.1245, is not considered an eligibility methodology.

            e.                Valuation of life estates and remainder interests. In the absence of other evidence, the value of a life estate or remainder interest in property shall be determined using the following table by multiplying the fair market value of the entire underlying property (including all life estates and all remainder interests) by the life estate or remainder interest decimal corresponding to the age of the life estate holder or other person whose life controls the life estate.

If a Medicaid applicant or recipient disputes the value determined using the following table, the applicant or recipient may submit other evidence and the value of the life estate or remainder interest shall be determined based on the preponderance of all the evidence submitted to or obtained by the department, including the value given by the following table.

Age	Life Estate	Remainder		Age	Life Estate	Remainder		Age	Life Estate	Remainder
0	.97188	.02812		37	.93026	.06974		74	.53862	.46138
1	.98988	.01012		38	.92567	.07433		75	.52149	.47851
2	.99017	.00983		39	.92083	.07917		76	.51441	.49559
3	.99008	.00992		40	.91571	.08429		77	.48742	.51258
4	.98981	.01019		41	.91030	.08970		78	.47049	.52951
5	.98938	.01062		42	.90457	.09543		79	.45357	.54643
6	.98884	.01116		43	.89855	.10145		80	.43569	.56341
7	.98822	.01178		44	.89221	.10779		81	.41967	.58033
8	.98748	.01252		45	.88558	.11442		82	.40295	.59705
9	.98663	.01337		46	.87863	.12137		83	.38642	.61358
10	.98565	.01435		47	.87137	.12863		84	.36998	.63002
11	.98453	.01547		48	.86374	.13626		85	.35359	.64641
12	.98329	.01671		49	.85578	.14422		86	.33764	.66236
13	.98198	.01802		50	.84743	.15257		87	.32262	.67738
14	.98066	.01934		51	.83674	.16126		88	.30859	.69141
15	.97937	.02063		52	.82969	.17031		89	.29526	.70474
16	.97815	.02185		53	.82028	.17972		90	.28221	.71779
17	.97700	.02300		54	.81054	.18946		91	.26955	.73045
18	.97590	.02410		55	.80046	.19954		92	.25771	.74229
19	.97480	.02520		56	.79006	.20994		93	.24692	.75308
20	.97365	.02635		57	.77931	.22069		94	.23728	.76272
21	.97245	.02755		58	.76822	.23178		95	.22887	.77113
22	.97120	.02880		59	.75675	.24325		96	.22181	.77819
23	.96986	.03014		60	.74491	.25509		97	.21550	.78450
24	.96841	.03159		61	.73267	.26733		98	.21000	.79000
25	.96678	.03322		62	.72002	.27998		99	.20486	.79514
26	.96495	.03505		63	.70696	.29304		100	.19975	.80025
27	.96290	.03710		64	.69352	.30648		101	.19532	.80468
28	.96062	.03938		65	.67970	.32030		102	.19054	.80946
29	.95813	.04187		66	.66551	.33449		103	.18437	.81563
30	.95543	.04457		67	.65098	.343902		104	.17856	.82144
31	.95254	.04746		68	.63610	.363690		105	.16962	.83038
32	.94942	.05058		69	.62086	.37914		106	.15488	.84512
33	.94608	.05392		70	.60522	.39478		107	.13409	.86591
34	.94250	.05750		71	.58914	.41086		108	.10068	.89932
35	.93868	.06132		72	.57261	.42739		109	.04545	.95455
36	.93460	.06540		73	.55571	.44429

         75.13(3) Resource eligibility for SSI-related Medicaid for children. Resources of all household members shall be disregarded when determining eligibility for children under any SSI-related coverage group except for those groups at subrules 75.1(3), 75.1(4), 75.1(6), 75.1(9), 75.1(10), 75.1(12), 75.1(13), 75.1(23), 75.1(25), 75.1(29), 75.1(33), 75.1(34), 75.1(36), 75.1(37), and 75.1(38).

This rule is intended to implement Iowa Code section 249A.3.