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June 2021

G06 (ImpaCT) G06-COVID-19-Testing Coverage- Uninsured and Emergency Medical

• Coverage for uninsured citizens, permanent residents who do not qualify for HUSKY A, B, C or D • Emergency Medicaid for undocumented individuals who are not eligible for Medicaid (income limits apply to this group) • Individuals must apply through AHCT to establish eligibility for this coverage group • No age limit • Limited Benefit – COVID-19 test and related office visit only Income limits for undocumented individuals under Emergency Medicaid guidelines This medical coverage is only available during the Public Health Emergency that began March 18, 2020. HUSKY B --Did not exist in EMS HUSKY B—ImpaCT: Band 1—B01 Band 2—B02 Band 3—B03 (not available at this time) CP2—Presumptive Eligibility

This is not Medicaid

Title 21 of the Social Security Act HUSKY B CHIP Bands 1 and 2

• Children under age 19 (income over 196% of FPL (201% of FPL with 5% disregard) • Children may not have other medical coverage

Band 1 202%-254% of FPL (with 5% disregard) No monthly premium; Co-pays

Band 2 255%-323% of FPL (with 5% disregard) - Premium $30/mo for one child; $50/mo for 2 or more children Co-pays

No asset test

End of month in which child turns 19 H01—EMS H01—ImpaCT

2540.64

HUSKY A Individuals Receiving Home and Community Based Services (H01)

• Would be eligible for FMA as CN if in a LTCF (T01) • Qualify to receive home and CBS under a waiver approved by the Health Care Financing Administration AND would, without such services, require care in a LTCF. Use AFDC asset test

Gross income must be less than special CNIL, which is set at 300% of SSI amount Qualified for Medicaid as long as group conditions are met AND Individual receives home and community- based services under a waiver

H99—EMS H99—Code not used in ImpaCT

Existing code in EMS, but not a legitimate coverage group, as there is no spenddown provision for CBS cases

N/A

N/A