Page 10
June 2021
M06—EMS M06—ImpaCT
1902(a)(10)(A)(ii)(XII) 1902(z) Tuberculosis Coverage Group (HUSKY-- Limited Benefits)
Individual must be diagnosed with Tuberculosis as a requirement • Household of one • Retro Medicaid allowed • Only covers treatment of Tuberculous Processed by TB liaison
No income or asset test No duration
M07—EMS M07—ImpaCT
1902(a)(10)(A)(ii)(XXI) 42 CFR 435.214
Presumptive Eligible Family Planning (HUSKY--Limited Benefit)
Effective 3/1/12 Presumptive Eligible coverage Limited Benefit coverage for family planning services and family planning related services • Must be of Childbearing age and can’t be pregnant • US Citizens or Qualified Non-Citizens • Resident of CT • No eligibility if eligible for another coverage group • W-1PE (application) and W-538 (PE Voucher) is needed with each PE submission
It allows Qualified Entities to temporarily grant Family Planning and then send the completed application form to RPU at DSS
The RPU (Regional Processing Unit) staff will grant PE coverage. The client and/or their CAC pursues ongoing medical coverage via AHCT
Income 258% of FPL (263% of FPL with the 5% disregard)
No asset test W-538 (Paper voucher) given to client is good for 10 calendar days.
PE coverage period - In most cases, lasts until end of second month
ImpaCT will automatically close PE coverage at the end of the second month if client is not found eligible for Medicaid
Denied ongoing Medicaid, RPU staff review for ongoing Family Planning LB coverage
If voucher is given to ineligible client, then PE may end earlier.
PE eligibility for family planning allowed two times per calendar year
M08—EMS M08—ImpaCT
1902(a)(10)(A)(ii)(XXI) 42 CFR 435.214
Family Planning (HUSKY-- Limited Benefit)
Effective 3/1/12 Ongoing limited coverage for family planning services and family planning related services • Must have been denied MAGI Medicaid • Must be of childbearing age and cannot be pregnant • US Citizens or Qualified Non-Citizens • Resident of CT
Income 258% of FPL (263%)
No asset test As long as eligible and not eligible for Medicaid M09 (MAGI)—EMS M09 (MAGI)—ImpaCT
42 CFR 435.150 1902(a)(10)(A)(i) (IX) HUSKY A Former Foster Care
• This coverage group if for youths that were in Connecticut DCF care at the age of 18 and on Medicaid.
Staff in Eligibility Policy and Program Support will grant these cases No income/ assets are counted for this coverage group Eligible from age 18 up to their 26th birthday