Long Term Care (LTC): Categorical Relationship

Determining Categorical Relationship

To be eligible for SoonerCare/Medicaid Long-Term Care services an individual must first meet the description of a member eligibility group as shown below. Categorical relationship to disability or blindness is established by the Social Security Administration (SSA).

An individual who is not ABD-related meets the categorical relationship requirement if s/he is receiving TANF or is in OHCA’s online enrollment population. OHCA online enrollment eligibility can be verified through MMIS using the clients name and Social Security Number or by checking iCE eligibility.

For Nursing Home an individual must be:

  • Aged (65 or older) or
  • Disabled or blind as defined above
  • Non-ABD as defined above (Both Online Enrollment and TANF individuals must establish an ABD categorical relationship within the first year of eligibility).

For ADvantage Waiver an individual must be ABD related:

  • Aged (65 or older) or
  • Age 21 or older if physically disabled and not developmentally disabled, or
  • Developmentally disabled between the ages of 21 and 65 and does not have an intellectual disability or a cognitive impairment related to the developmental disability

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