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Health Benefits Eligibility and Enrollment Rules (HBEE)

The Health Benefits Eligibility and Enrollment (HBEE) rules provide the eligibility standards for Medicaid and other health care programs. Adopted and proposed HBEE rules can be found below.

HBEE Adopted Rules (by Part)
 

HBEE Part 1 - General Provisions and Definitions (*GCR 20-001 through 20-005 HBEE adopted rules (Parts 1, 5, 7, 8) were filed with the Secretary of State on 7/27/2021 and are effective 10/1/2021)

HBEE Part 2 - Eligibility Standards

HBEE Part 3 - Nonfinancial Eligibility Requirements

HBEE Part 4 - Special Rules for Medicaid Coverage of Long-Term Care Services

HBEE Part 5 - Financial Methodologies (*GCR 20-001 through 20-005 HBEE adopted rules (Parts 1, 5, 7, 8) were filed with the Secretary of State on 7/27/2021 and are effective 10/1/2021)

HBEE Part 6 - Small Employer Health-Benefits Program Rules

HBEE Part 7 - Eligibility-and-Enrollment Procedures (*GCR 20-001 through 20-005 HBEE adopted rules (Parts 1, 5, 7, 8) were filed with the Secretary of State on 7/27/2021 and are effective 10/1/2021)

HBEE Part 8 - State Fair Hearings and Expedited Eligibility Appeals (*GCR 20-001 through 20-005 HBEE adopted rules (Parts 1, 5, 7, 8) were filed with the Secretary of State on 7/27/2021 and are effective 10/1/2021)

HBEE Rules Parts 1 - 8 (Effective 10/1/2021)


Proposed HBEE Rules

The following parts of HBEE are open for public comment through August 24, 2022:

Please see Proposed GCR 22-029 through 22-033 for further details, including how to submit a public comment.

 


Repealed Medicaid Rules
 

5300 VHAP - REPEALED (except retain 5321 - 5323)

4100 Medicaid - REPEALED effective 1/1/14 replaced with Health Benefits Eligibility and Enrollment

4200 Medicaid SSI - REPEALED effective 1/1/14 replaced with Health Benefits Eligibility and Enrollment

4300 Medicaid ANFC - REPEALED effective 1/1/14 replaced with Health Benefits Eligibility and Enrollment

4400 Medicaid Spenddown - REPEALED effective 1/1/14 replaced with Health Benefits Eligibility and Enrollment