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Medicaid Eligibility Manual Abbreviations/Acronyms/Definitions

Issued November 13, 2025 Page 7 of A-200 Replaces January 27, 2025

Revised/added text indicated by underscore Deleted text indicated by “**”

Excluded Resource – A resource that is not counted in determining eligibility.

Exploitation – The illegal or improper use of funds, assets, or property, or the improper use of a power of attorney or guardianship.

Extended Medicaid – Medicaid coverage for those individuals who lose for SSI or Mandatory State Supplement (MSS) eligibility and meet all eligibility requirements for PICKLE, DAC, DW/W, EW/W, or DW/W with no SGA programs.

Extortion – Taking something of value from a person by force, intimidation, or abuse of legal or official authority.

F

Fair Hearing – A legal proceeding in which the applicant/beneficiary and Medicaid agency representative presents the case being appealed in front of an impartial hearing officer.

Fair Market Value – An estimate of the value of an asset, if sold at the prevailing price at the time it was actually transferred.

Family Opportunity Act – A buy-in program for children with disabilities whose family’s gross income is at or below 300% FPL.

Federal Benefit Rate – The maximum SSI payment.

Fiscal Intermediary – The contractor, managed by the MES section, which processes claims, issues payments to providers, handles provider inquiries and complaints, provides training for providers, and issues medical eligibility cards to a beneficiary.

For the Sole Benefit of – This phrase means to benefit one person only.

Former Foster Care Children – Individuals under 26 years of age, who were receiving Medicaid and were in foster care under the responsibility of the state at the time of their 18th birthday.

Fraud – The willful intent to obtain ineligible benefits or payments.

G