Deviation from financial eligibility formula set forth in Medicaid Manual improper.

Topic: Medicaid Eligibility, Decided by Judge Schroer 
Docket Number: ***** , Decision Date: 2015-06-29 
Attachment: Click here to download the decision. 

Petitioner was properly denied Medicaid under the “Qualified Medicare Beneficiary” class of assistance, as her total net income exceeded the income limit for that Medicaid category.  Petitioner is eligible for, and will continue to receive, “Specified Low-Income Medicare Beneficiary” Medicaid.  The Court has no authority to deviate from the formula for determining the financial eligibility of applicants set forth in the Medicaid Manual.