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COMAR 10.09.24.03

408 State of Maryland Medical Assistance Manual Revised July 2012

Section 300 Frequently Asked Questions and Answers Coverage Groups

1. What is a coverage group? A coverage group is a group of persons who must satisfy a common set of requirements for determining eligibility for Medical Assistance 2. What is a “Track” and what are some of the most common ones? A track is a group of related coverage groups. Currently there are 11 tracks. The same eligibility rules are used for all coverage groups in the same track. Children placed in foster care or subsidized adoptions (E-Track) Low income pregnant women and children in the Maryland Children‟s Health Program (MCHP) (P-Track) Uninsured children under the age of 19 whose income is above 200% but below 300% of the Federal Poverty Level. (D-Track) Aged, blind, or disabled individuals (ABD) (S-Track) Refugees (G-Track) Family and Children (FAC) –F-Track Aliens (X02) Long term care (LTC) cases have their own tracks, o ABD individuals (L-Track) o Children and Temporary Cash Assistance (TCA) adults and Family Long Term Care (T-Track)

3. What is the Pickle Amendment?

Under the Pickle Amendment the program establishes Medical Assistance eligibility for certain former SSI recipients who currently receive Social Security benefits. These are the persons who would still be eligible for SSU payments if their income were reduced by the total amount of all Social Security Cost of Living Adjustments (COLAS) received since their SSI was terminated. The person would be deemed as a SSI recipient. 4. Can an ineligible or illegal pregnant woman apply for Labor and deliver only service prior to birth? Yes, the ineligible or illegal pregnant immigrant can now file an application with the (LDSS) and LHD prior to the birth of a child. 5. Is it possible to be dually eligible for Medicare and MA services? Yes, a recipient in QMB Buy-in only program, that meets spend-down is considered dual eligible.