Page 8

Chapter: 0200 General Program Information Program: MFAM 6 5. Family Planning – Medicaid for women ages 14 through 55 6. Emergency Medical Assistance for Noncitizens 7. Former Foster Care Children 0230.0103 Eligibility Criteria (MFAM) Eligibility criteria include residency, identity, U.S. Citizenship or proper noncitizen status, possession of a Social Security number, cooperation with the child support program, assignment of rights for third party payments and income. 0230.0104 Medically Needy (MFAM) The Medically Needy Program provides coverage for individuals who meet the technical requirements for the above coverage groups, but whose income exceeds the group’s income standard. Medically Needy has no income limit. Individuals are enrolled in the program with a Share of Cost (SOC). SOC refers to the amount of medical bills which an individual enrolled in the Medically Needy Program must incur in any given month before Medicaid coverage may be authorized. 0230.0105 Emergency Medical Assistance for Noncitizens (MFAM) This program provides emergency Medicaid coverage for noncitizens who would otherwise be eligible for Medicaid except for their noncitizen status. They must meet all technical requirements except for citizenship, child support enforcement cooperation, welfare enumeration and the requirement to file for Social Security benefits.

To be eligible for emergency Medicaid benefits, the noncitizen must meet the income requirements for whichever Medicaid coverage group the noncitizen is determined to be eligible.

Medicaid coverage is for the duration of the emergency medical situation only, as certified by a health professional. This includes emergency labor and delivery. 0230.0106 Family Planning Services (MMFP) This coverage group provides family planning (MMFP) services for women ages 14 through 55, who have lost their Medicaid eligibility due to postpartum coverage ending, income changes, disability ended, due to a CSE sanction, or aging out of a previous Medicaid category (e.g., age out of MM C, MO Y). The Family Planning services include: 1. Yearly family planning 2. Preconception counselling 3. Pregnancy Tests 4. Screening and treatment of sexually transmitted infections 5. Outpatient sterilization services 6. Family planning related lab work.

Eligibility is limited to two years after losing Medicaid coverage, subject to a 12-month coverage period. Individuals found eligible will not be required to report changes in income or household size for the 12-month period of eligibility. Individuals must reapply for coverage at the expiration of the first 12-month coverage period for an additional 12 months of coverage with a maximum of 24 months. The 24-month count begins the first month following the last month of full coverage Medicaid. MMFP eligibility begins at ex parte or in the month of application. If the woman regains full coverage Medicaid and then loses it again, the 24-month period “resets”.