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• QI-1 (Note that effective July 1, 2005, there are no QI-1 eligible customers, since the QMB and SLIMB income limits have been increased to include these customers) • QDWI RR • Refugees, asylees, and certain other immigrants in their first eight months in the country LT • Individuals in a LTC facility MC • Effective May 1, 2010, this program type is used for both the DC HealthCare Alliance and for Medicaid for Childless Adults

Individuals eligible for emergency Medicaid services only are assigned the program type that they would have been in had they not been ineligible due to immigration status. These individuals receive a separate code that indicates they are eligible for emergency services only.

The SSR should encourage individuals applying for and/or qualifying for MA under SR to apply for SSI at a Social Security Office. The SSR should explain that since SR MA uses the same income, asset, and disability standards as SSI, individuals eligible under SR are likely to be SSI-eligible. The SSR should inform individuals qualifying for SR of the benefits of receiving SSI (i.e., cash assistance to meet basic needs and no need to recertify Medicaid eligibility as long as they continue to receive SSI).

Determining MA Eligibility 2.2.3

The SSR must determine the ACEDS MA program type, using the following guidelines, under which each applicant may be potentially eligible for MA:

 SSI recipients are always in an SR unit.  TANF recipients are always in an AR unit.  MA eligibility for parents, children, and caretaker relatives is always tested under the AR program type before the AX program type.  Parents, caretaker relatives, and children ineligible for MA through the AR or SR types should be tested under the AX type.  If a child is not receiving SSI but could qualify as either an SR or AR/AX case, the SSR should initially evaluate the child as an AR/AX case because this does not require a disability determination.  If a parent or caretaker relative is not receiving SSI but could qualify as either AR/AX or SR, the SSR should: o initially evaluate the parent/caretaker relative as an AR or AX (whichever is appropriate given his/her income), and o explain that if s/he returns the completed medical evaluation form, and is determined to be disabled by the Medical Review Team, s/he will not be placed in managed care.

While SSRs must select the ACEDS MA program type under which MA eligibility will be tested, ACEDS will determine the income category in which an individual fits if the individual is eligible for MA within the SSR- selected program type.