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June 2021

X01 (MAGI)*—EMS X01 (MAGI)*—ImpaCT

42 CFR 435.116 1902(a)(10)(A)(i)(III) And (IV); 1902(a)(10)(A)(ii)(I), (IV) and (IX); 1931(b) and (d); 1920

HUSKY A Pregnant Women

Covers pregnant women whose family income does not exceed 263% of Federal Poverty Level (includes 5% disregard)

See handout ‘C’ for assistance

Once eligible, remains eligible for duration of pregnancy. Also eligible for 60 days post-partum coverage after child’s birth

Effective 01/01/14, 258% of FPL (263% of FPL with the 5% disregard)

Unborn child included in needs group

No asset test Duration of pregnancy

Once eligibility is established, continues for remainder of pregnancy, even if change in income.

*** X01 coverage extended for 2 months after birth month of child to cover post-partum coverage

X02 (MAGI)—EMS X02 (MAGI)—ImpaCT

1902(a)(10)(A)(i)(VIII) 42 CFR 435.119 HUSKY D MCLIP- Medical for Low Income Persons

For individuals and married coupled who are: • Age 19-64 • not Medicare recipients • not Pregnant • Have no dependents under the age of 19

See handout ‘C’ for assistance

Effective 1/1/14, 133% of FPL (138% of FPL with the 5% disregard)

No asset test As long as all eligibility requirements are met X03 (MAGI)—EMS X03 (MAGI)—ImpaCT

408(a)(11)(A); 1902(a)(52); 1902(e)(1)(B) 1925 1931(c)(2) HUSKY A Transitional Medical Assistance (TMA)

For people who lose eligibility for Husky A for Families (X07 and X25) under these circumstances: • Connecticut resident • Has child(ren) under 19 living in the home • Discontinued from HA for parent/caretakers or children due to increased earned income • Must have received at least one month of active HA • Addition of household member with earnings does not count as increased earned income

No income or asset test Up to12 months (1st month being month following X07/X25 ineligibility)

Or if no longer child < 19 in home, moves out of state, death or assistance unit applies and is found eligible for another Medicaid group

X04 (MAGI)—EMS X04 (MAGI)—ImpaCT

42 CFR.115; 408(a)(11)(B); 1931(c)(1) Husky A Extended Medical Assistance (EMA)

For people who lose eligibility for Husky A for Families (X07 and X25) under these circumstances: • Connecticut resident • Has child(ren) under 19 living in the home • Discontinued from HA for parent/caretaker or children due to new or increased income from spousal support or TFA terminated because of collection of child support Title IV-D • Must have received at least one month of active HA

No income or asset test Up to12 months (1st month being month following X07/X25 ineligibility)

Or if no longer child < 19 in home, moves out of state, death or assistance unit applies and is found eligible for another Medicaid group