Certification Requirements

Institutionalized individuals who are eligible for, or in receipt of standard medical assistance services under one of the existing coverage types meet the categorical eligibility criteria for nursing home or home and community based care under a Long Term Care program. Institutionalized individuals who are currently not in receipt of or eligible for another Medical Assistance coverage type, but who are aged, blind or disabled according to SSA disability criteria also meet the categorical eligibility criteria. Level of Care certification must be received, and it must be current, must be completed by a qualified physician within a specified time period prior to application for Long Term Care, and must be re-evaluated on a regular basis as specified by the state.