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Chapter: 2000 Coverage Groups Program: MSSI, SFP 12 2030.1400 MEDICALLY NEEDY COVERAGE (MFAM) The Medically Needy Program is for individuals who meet the technical requirements of one of the above coverage groups but whose income exceeds the income limit. If the household’s income is greater than the income limit, the exceeding amount is determined as the share of cost. The individual is enrolled but is not eligible until the share of cost is met. Medically Needy provides month-to-month coverage when individuals have incurred medical bills that meet their share of cost.
2040.0000 SSI-Related Medicaid, State Funded Programs If financial and technical requirements have been met, the assistance group may be eligible for the coverage groups described in this section.
Additionally, this section provides the category codes for each coverage group used in FLORIDA. 2040.0100 CATEGORY CODES (MSSI) The following section details the category codes for FLORIDA.
Please note that the following programs are not part of FLORIDA:
1. State Funded Assistance Programs, 2. Optional State Supplementation, 3. Personal Needs Allowance Supplement, and 4. Home Care for the Disabled Adult. 2040.0107 SSI-Related Medicaid Category Codes (MSSI) 1. MS = SSI Medicaid for SSI direct assistance recipients 2. Protected SSI Medicaid a. MT-C = Regular COLA b. MT-W = Widows II c. MT-D = Disabled Adult Children 3. MM-S = MEDS for aged or disabled 4. ML-S or NL-S for Medically Needy = Emergency Medical Assistance for Noncitizens 5. NS = SSI-Related Medically Needy 6. Institutional Care Program (ICP) a. MI-S = SSI eligible b. MI-I = Regular c. MI-T = Transfer of Assets d. MI-M = MEDS 7. Hospice Services a. MH-S = SSI eligible b. MH-H = Regular c. MH-M = MEDS 8. Home and Community Based Services (HCBS) a. MW-A = All HCBS waivers b. For PACE individuals in the community, the category will be MWA. If the PACE individual is placed in a nursing home, the code will change to the appropriate ICP code. 9. Medicare Savings Programs a. QMB = Qualified Medicare Beneficiaries (QMB) b. WD = Working Disabled c. SLMB = Special Low Income Medicare Beneficiary (SLMB) d. QI-1 = Qualifying Individual 1 (QI-1)