The question of whether AABD is the same as Medicaid is common, and the short answer is no. Medicaid is the overarching federal and state program that provides health coverage to certain low-income adults, children, and people with disabilities. AABD, which stands for Aged, Blind, and Disabled, is a specific eligibility pathway that individuals must meet to qualify for Medicaid benefits. This classification is designed for individuals whose eligibility is based on age or a medical status, in addition to financial need.
Medicaid: The Overarching Program
Medicaid is a public health insurance program established in 1965 under Title XIX of the Social Security Act. It operates as a partnership, jointly funded by the federal government and individual states, allowing for significant variation in administration. Federal law sets broad guidelines and mandatory coverage groups, but each state designs its own program, including specific eligibility criteria and the scope of covered services.
States must provide coverage for mandatory populations, such as low-income children, pregnant women, and certain elderly or disabled individuals, to receive federal matching funds. States also have the option to cover additional groups, such as those included under the Affordable Care Act’s expansion. Eligibility and the services received depend heavily on the state of residence.
Because Medicaid is managed by state agencies, the specific income limits, resource tests, and application processes are not uniform nationwide. Eligibility is determined by meeting both a categorical requirement and a financial requirement set forth in the state’s plan. AABD is one of the most significant pathways within this federal framework for long-term support.
AABD: The Specific Eligibility Classification
The Aged, Blind, and Disabled (AABD) classification is a foundational categorical eligibility group within the Medicaid program. This category is designed for individuals who are age 65 or older, legally blind, or determined to have a qualifying disability. While some states may use a different label, the underlying federal criteria for age, blindness, and disability status remain the standard.
Qualification under the AABD category is important because it often grants access to a more comprehensive set of benefits than other Medicaid pathways. Individuals who qualify through AABD are typically eligible for Long-Term Services and Supports (LTSS). These services include nursing home care and home and community-based services that provide assistance with daily activities.
The federal standard for disability aligns with the definition used by the Social Security Administration (SSA). It requires an inability to engage in substantial gainful activity due to a medically determinable impairment expected to last at least 12 months or result in death. Meeting the AABD classification serves as the non-financial gateway to eligibility for this specific population.
Financial and Medical Requirements for AABD
Qualifying for AABD Medicaid involves meeting the dual requirements of categorical status and financial need regarding income and assets. The medical determination of blindness or disability is based on the Social Security Administration’s established standards. The financial criteria for AABD are fundamentally linked to the Supplemental Security Income (SSI) program, which provides federal cash assistance to individuals with limited resources.
SSI States
Most states, often called “SSI states,” simplify the process by granting automatic Medicaid eligibility to anyone who receives SSI benefits. If the SSA determines a person is disabled and financially eligible for SSI, that person is automatically considered eligible for AABD Medicaid without a separate state application. This direct link streamlines the process for financially vulnerable individuals.
209(b) States
A minority of states, known as “209(b) states,” use more restrictive financial criteria than the federal SSI program for AABD Medicaid eligibility. In these states, an individual may receive SSI payments but must apply separately for Medicaid and meet the state’s own income and asset limits. These 209(b) states must offer a “spend-down” provision, which allows applicants with income above the limit to become financially eligible by incurring medical expenses that reduce their effective income to the state’s threshold.
The income and asset limits for AABD are typically much lower than for other Medicaid groups. The asset limit is often set at $2,000 for an individual and $3,000 for a couple, though certain assets like a primary residence and one vehicle are usually excluded. The medical determination of disability involves a rigorous five-step sequential evaluation process to confirm the severity and duration of the impairment.