Page 37

MISSISSIPPI DIVISION OF MEDICAID Eligibility Policy and Procedures Manual CHAPTER 101 – Coverage Groups and Processing Applications and Reviews Page |232

Effective Month: December 2016

Applications Filed With the Federally Facilitated Marketplace (FFM) (Continued) • AT’s received from the FFM are evaluated for MAGI-related coverage initially but if any household member indicates on the AT that a disability exists or if the individual is aged, that household member is evaluated for ABD coverage. • The “insurance affordability program” referenced above is a term that includes Medicaid, CHIP and coverage in a qualified health plan through the FFM that provides advance payments of a premium tax credit or cost-sharing reductions to qualified individuals. • MAGI-related denials that do not indicate possible ABD eligibility are automatically referred to the FFM for an evaluation of coverage in other insurance affordability programs. Non-Medicare ABD denials are also referred to the FFM for an evaluation of coverage. NOTE: Referrals to the FFM are made upon denial provided the application is not denied for administrative reasons, such as, failure to comply with application requirements, voluntary withdrawal or any other denial due to failure to complete the application process.