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June 2021
MEDICAL COVERAGE GROUPS (UPM 2540)
Click on the blue hyperlinks to see the UPM policy *includes the general 5% FPL income disregard
EMS/ImpaCT Codes
Group Title and Definition
Income/Assets
Duration A02—EMS A02—ImpaCT
8035.05 CADAP Connecticut AIDS Drug Assistance Program
• Pays for medication approved by U.S. Food and Drug Administration to treat HIV disease and HIV disease related conditions • Must be diagnosed by licensed Health Practitioner as having HIV • If eligible for other health insurance, must apply for and use that insurance first
Total family income at or below 400% of FPL
No asset test As long as all eligibility requirements are met
Renewals to be completed every 6 months
As of 11/01/18, DPH began administering this program D01—EMS D01—ImpaCT
2540.40 HUSKY A Children Receiving Title IV-E Payments (D01)
• Children eligible for adoption assistance or foster care payments under Title IV-E
Must be within Title IV-E limits (DCF determines eligibility for Title IV-E)
DCF records eligibility for the cases that are categorically eligible As long as child receives Title IV-E payments