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MISSISSIPPI DIVISION OF MEDICAID Eligibility Policy and Procedures Manual CHAPTER 101 – Coverage Groups and Processing Applications and Reviews P a g e | 35 Effective Month: September 2023

Applications Filed with the Federally Facilitated Marketplace (FFM) Applications for MAGI-related Medicaid or CHIP may also be filed on-line with the Federally Facilitated Marketplace or FFM. The FFM is also referred to as the health insurance exchange. An FFM operates in states that choose not to build their own state-operated exchange. The FFM for MS determines eligibility for enrollment in qualified health plans and insurance affordability programs and assists in determining eligibility for Medicaid and CHIP by verifying certain application information through a Data Services Hub. If an individual or family appears to be eligible for Medicaid or CHIP based on Hub verified data, the FFM transfers the electronic account, referred to as an Account Transfer, to MS for completion of the application. • An individual who applies for Medicaid coverage in MS through the FFM has their electronic application information transferred to DOM via a process referred to as an Account Transfer (AT). • 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.