Family Medicaid

The statement of the A/R may be accepted as verification for all Basic Eligibility Criteria unless there is information known to the agency that conflicts with the statement of the A/R or if the statement is otherwise questionable.

EXCEPTION:

Citizenship/Immigration Status/Identity

Any information that conflicts with information known to the agency, or that is otherwise questionable must be verified.

The following charts list Basic Eligibility Criteria and the COAs to which each applies.

CHART 2201.1 ABD MEDICAID BASIC ELIGIBILITY CRITERIA ABD MEDICAID CLASS OF ASSISTANCE AGED / BLIND / DISABLED CITIZENSHIP/ IMMIGRATION STATUS / IDENTITY ENUMERATION LENGTH OF STAY LEVEL OF CARE RESIDENCY THIRD PARTY LIABILITY SSI Medicaid (SSI) X X X X X Pickle (PL 94-566) X X X X X Disabled Adult Child (PL 99-643) X X X X X Former SSI-Disabled Child X X X X X Disabled Widow(er) X X X X X Widow(er) Age 60-64 (PL 100-203) X X X X X 1984 Widow(er) (PL 99-272) X X X X X 1972 COLA (PL 92-603) X X X X X Elderly Disabled Waiver Program (EDWP) X X X X X X X New Options Waiver (NOW) X X X X X X X Comprehensive Supports Waiver Program (COMP) X X X X X X X Deeming Waiver X X X X X X Hospice (at home or institutionalized) X X X X X X X 30 Day Hospital X X X X X X X Independent Care Waiver Program (ICWP) X X X X X X X Nursing Home X X X X X X X QMB X X X X X SLMB X X X X QI-1 X X X X QDWI X X X X X ABD Medically Needy (AMN) X X X X X

CHART 2201.2 FAMILY MEDICAID BASIC ELIGIBILITY CRITERIA FAMILY MEDICAID CLASS OF ASSISTANCE AGE CITIZENSHIP/ IMMIGRATION STATUS / IDENTITY COOPERATION WITH DIVISION OF CHILD SUPPORT SERVICES * ENUMERATION LIVING WITH A SPECIFIED RELATIVE / TAX FILER / NON TAX FILER RESIDENCY THIRD PARTY LIABILITY Parent/Caretaker with Child(ren) Medicaid X X X X X X X Transitional Medical Assistance (TMA) X X X X X X Four Months Extended (4MEx) X X X X X X Newborn X X X X Children Under 19 Years of Age X X * X X X X Pregnant Woman (PgW) X X X X State Adoption Assistance (SAA) Medicaid X X X X X X X Child Welfare Foster Care (CWFC) Medicaid X X X X X X Former FosterCare Medicaid X X X X X Women’s Health Medicaid X X X X X Pathways X X X X X X Planning For Healthy Babies (P4HB) X X X X X PeachCare for Kids® X X X X X X Family Medicaid Medically Needy X X X X X X X

* No referral to Child Support Services is made for child-only Medicaid cases. Refer to Section 2250 - Cooperation with Division of Child Support Services for definition of a child-only Medicaid AU.