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carrying one child on their health insurance and the child is not receiving Medicaid, but a sibling is on Medicaid; or if the children are covered in categories such as MA X or MASI which are at the top of the Medicaid hierarchy. MA F formation is needed to provide a budget which will pull in all required members and count all their income when determining continued TMA eligibility.

During TMA, childcare expenses paid by the household for the dependent children can be added as a deduction on the MAGI income screen for their parent or non-parental caretaker. When TMA ends, the deduction does not affect MAGI budgeting any longer.

For the first six (6) months of TMA, there is no income limit for the family. After that time, the income limit is 185% FPL (MAGI 5% disregard will not apply).

3810.15.00 POWER ACCOUNT CONTRIBUTION (PAC) AND TMA

All members who qualify for TMA will be placed into HIP State Plan Plus coverage. Members are responsible for paying their PAC amounts each month during the TMA period; however, no closure action will be taken for non-payment of PAC until after the member has received a full six (6) months of TMA coverage. If the member’s MCE sends a no-pay record in the protected initial 6-month period, the record will be rejected.

The PAC amount for TMA members will be set at $20, the maximum PAC tier. Because TMA protection is given to a member who was otherwise over income for the HIP program, the PAC will not fluctuate along with income during a TMA period. Any tobacco-use surcharge will be based on the $20 TMA PAC and added by the MCE.

NOTE: The member can request to be removed from the TMA protections if their income decreases and they can no longer afford the $20 PAC. This would need to be called into the Help Desk to remove the TMA indicator.

Married TMA couples will have their PAC split if both members remain on TMA. If one parent leaves the TMA household but the second parent retains TMA, the second parent will be responsible for the full TMA PAC amount.

Unmarried parents will not receive the couple split, per normal HIP rules.

3815.00.00 TMA ELIGIBILITY PERIODS

To receive TMA coverage for the maximum twelve (12) months, in addition to the criteria already listed, the family with TMA HIP and MA F must also meet the additional eligibility guidelines listed below.

Members who lose all eligibility due to reasons other than noncompliance or voluntary withdrawal will be electronically sent to be considered for eligibility through the Federally Facilitated Marketplace (FFM). Members may voluntarily withdraw from TMA HIP and/or MA F