AFS Policy: Categorical Relationship

Categorical relationship – a term used in the SoonerCare (Medicaid) Program that means the individual meets basic eligibility requirements for an eligibility group.  An adult must be pregnant, have children under the age of 18 in the home, be 65 years of age or older, or meet the Social Security Administration’s definition for being disabled or blind to qualify for medical benefits.  Policy regarding this term is located at:

  • SoonerCare (Medicaid[ABD]): 
    • 317:35-1-2. Definitions;
    • 317:35-5-2. Categorically related programs;
    • 317:35-5-3. Determining categorical relationship to the aged;
    •  317:35-5-4. Determining categorical relationship to the disabled;
    • 317:35-5-5. Determining categorical relationship to the blind;
    • 317:35-5-47. Determination of income and resources for categorical relationship to Disability for TB infected individuals;
    • 317:35-5-49. Determination of income and resources for categorical relationship to TEFRA;
    • 317:35-7-36. Financial eligibility of individuals categorically related to ABD;
    • 317:35-7-38. Financial eligibility of categorically needy individuals related to ABD;
    • 317:35-7-40. Eligibility as Qualified Medicare Beneficiary Plus;
    • 317:35-7-41. Eligibility as Qualified Disabled and Working Individual;
    • 317:35-7-43. Eligibility as Specified Low-Income Medicare Beneficiaries;
    • 317:35-7-44. Eligibility for TB related services;
    • 317:35-7-46. Eligibility as Qualifying Individuals;
    • 317:35-9-45. Determination of medical eligibility for care in a private Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID);
    • 317:35-7-60. Certification for SoonerCare;
    • 317:35-9-67. Determining financial eligibility of categorically needy individuals;
    • 317:35-17-9. General financial eligibility requirements for the ADvantage program;
    • 317:35-17-10. Determining financial eligibility/categorical relationship for the ADvantage program;
    • 317:35-19-2. Nursing Facility (NF) program medical eligibility determination; and
    • 317:35-19-20. Determining financial eligibility of categorically needy individuals.
  • SoonerCare (Medicaid)[OE]: 
    • 317:35-1-2. Definitions;
    • 317:35-5-2. Categorically related programs;
    • 317:35-5-6. Determining categorical relationship to pregnancy-related services;
    • 317:35-5-6.1. Determining categorical relationship for pregnancy related services covered under Title XXI;
    • 317:35-5-8. Determining categorical relationship for the SoonerPlan Family Planning Program;
    • 317:35-5-45. Determination of income and resources for children and parents and caretaker relatives;
    • 317:35-5-46. Determination of income and resources for categorical relationship to pregnancy-related services;
    • 317:35-6-36. Financial eligibility of individuals categorically related to AFDC or pregnancy-related services; and
    • 317:35-6-37. Financial eligibility of categorically needy individuals related to AFDC or pregnancy-related services.

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