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benefits because of increased earnings. Eligible for Title XIX (Medicaid) reimbursement. 930 12 mos. AFDC/TANF related adult meeting medically needy eligibility requirements with income less than the AFDC/TANF financial assistance standard. Eligible for Title XIX (Medicaid) reimbursement. 930H initially, 4 mos. Parent, adult caretaker or pregnant individual who is eligible for Medicaid and who is a hurricane/natural disaster evacuee now living in DC. 930Q 12 mos. AFDC/TANF related adult meeting medically needy eligibility requirements with income less than the AFDC/TANF financial assistance standard. Dually eligible for Title XVIII (Medicare) and XIX (Medicaid) reimbursement as a QMB and/or SLMB. Note: effective July 1, 2005, SLMB eligibility is only for the month of application and any eligibility during the 90-day retroactive period. 938 4 mos. AFDC/TANF child eligible for extended coverage for four months because of increased child support. Eligible for Title XIX (Medicaid) reimbursement. 938G 3 mos. AFDC/TANF related adult eligible for six additional months due to termination of coverage because of increased earnings or hours of employment of a member of the AFDC/TANF family unit. Eligible for Title XIX (Medicaid) reimbursement. 940 12 mos. Blind person meeting medically needy eligibility requirements with income less than the SSI payment standard but not receiving SSI. Eligible for Title XIX (Medicaid) reimbursement.

940Q 12 mos. Blind 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. 943 12 mos. Processed by LTC unit only Blind person with income less than the SSI payment standard but not receiving SSI, and who is subject to long term care eligibility financial provisions. Eligible for Title XIX (Medicaid) reimbursement.