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910 12 mos. Aged person meeting medically needy eligibility requirements with income less than the SSI payment standard but not receiving SSI. Eligible for Title XIX (Medicaid) reimbursement.

910H initially, 4 mos. Aged person eligible for Medicaid who is a hurricane/natural disaster evacuee now living in DC. Eligible for Title XIX (Medicaid) reimbursement. 910Q 12 mos. Aged person meeting medically needy eligibility requirements with income less than the SSI payment standard but not receiving SSI; also meets requirements of a QMB and/or SLMB. Dually eligible for Title XVIII (Medicare) and XIX (Medicaid) reimbursement. Note: effective July 1, 2005, SLMB eligibility is only for the month of application and any eligibility during the 90-day retroactive period. 913 12 mos. Processed by LTC unit only Aged person receiving income less than SSI payment standard but not receiving SSI, and who is subject to long term care financial provisions. Eligible for Title XIX (Medicaid) reimbursement. 913Q 12 mos. Processed by LTC unit only Aged person receiving income less than SSI payment standard but not receiving SSI, and who is subject to long term care financial provisions; also meets requirements of a QMB and/or SLMB. Dually eligible for Title XVIII (Medicare) and XIX (Medicaid) reimbursement. Note: effective July 1, 2005, SLMB eligibility is only for the month of application and any eligibility during the 90-day retroactive period. 920 12 mos. AFDC/TANF related child meeting medically needy eligibility requirements with income less than the AFDC/TANF financial assistance payment standard. Eligible for Title XIX (Medicaid) reimbursement. 920H initially, 4 mos. Child eligible for Medicaid who is a hurricane/natural disaster evacuee now living in DC. Eligible for Title XIX (Medicaid) reimbursement. 928 4 mos. AFDC/TANF child eligible for extended coverage for four months because of increased child support. Eligible for Title XIX (Medicaid) reimbursement.

928G 6 mos. AFDC/TANF related child eligible for six additional months due to termination of Medicaid