Medicaid / Medicare Eligibility & Entitlement
In testing
Determine program eligibility and entitlement across MAGI and non-MAGI pathways, with a notice-ready rationale for every determination and redetermination.
19 July 2026
- Verification Report
- Included
- Integration Guide
- Included
- Performance Report
- Included
- MCP endpoint
- Included
- Demo interface
- Included
- Demo Video
- Not included
The decision, and the evidence it returns
Every call returns the outcome, a certainty factor, a fact identifier and the full evidence tree: the rules that fired, the facts they used and the reasoning that joined them. Backward chaining means the reasoning engine only asks for the data it needs.
Rainbird accelerators produce precise, deterministic and fully auditable decisions without calling an LLM for judgement, and each one can be pivoted to your policy and integrated over API or MCP.
What's inside, and how it's proven
One case is one applicant's determination, because households are person-specific by law: the same family yields a different household for each member, and the graph reproduces the CMS worked examples exactly. It assembles the MAGI household and countable income, tests categories in priority order, runs the non-MAGI aged, blind and disabled pathways under SSI methodology, determines Medicare entitlement and the dual-eligible ladder, and includes a redetermination mode that decides whether ex parte renewal succeeds before anything is requested from the member. Ineligibility is affirmative per-category arithmetic carrying hearing rights, never a default.
Redetermination adds renewal outcomes from Renewed Ex Parte to Coverage Terminated.
What ships when available
This accelerator is in testing. Register interest and you get the whole pack on the day of release.
Rainbird Graph (.rbird)
For importing into your Rainbird account.
Documentation
Verification report and integration guide.
Performance Report
Query performance and per-scenario latency.
MCP endpoint
Connect this knowledge graph to agentic platforms over MCP.
Core Evals
The 78 pure inject-query-assert studio tests.
Adversarial Evals
The 27 question-free adversarial tests.
Demo Interface
A demo interface to test the accelerator.
Demo Video
A demo video to explain the functionality.
This accelerator is open source under the MIT licence. It encodes public regulation, policy and research. You are free to download, inspect, adapt and redistribute the knowledge graph, its test suite and its documentation. Running it in production, with evidence trees, versioning and support, requires a Rainbird commercial licence.
Bring us the decision and we will build the graph
Contact us to discuss your decision use case.