Medicaid “Categorically Needy”
Eligibility Groups
- Individuals are generally eligible if they meet the
requirements for the Aid to Families with Dependent
Children (AFDC) program that were in effect in their
State on July 16, 1996.
- Children under age 6 whose family income is below
133% of theFederal
Poverty Level (FPL)
- Pregnant women whose family income is below 133% of
the FPL (services are limited to those related to
pregnancy, complications of pregnancy, delivery, and
postpartum care).
- Supplemental Security Income (SSI) recipients in most
States.
- Recipients of adoption or foster care assistance
under Title IV of the Social Security Act.
- Special protected groups (typically individuals who
lose their cash assistance due to earnings from work or
from increase Social Security benefits, but who ma keep
Medicaid for a period of time)
- All children born after September 30, 1983 who are
under age 19 whose family income is at or below the
FPL.
- Certain Medicare beneficiaries
