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COMBINED Medicaid 300 Nonfinancial Requirements

Supersedes: 7/1/2016

Reference: 42 CFR 435.403, .406, .920; ARM 37.82.101, .702, .1102, .1310; 42 USC 1396b; P.L. 119-21

Overview: After identifying who is included in the filing unit, determine which filing unit members are included in the assistance unit and will receive Medicaid. Each filing unit member's nonfinancial (SSN, age, community engagement requirements or exclusion, etc.) and financial criteria (income and resources, as applicable) are considered when determining eligibility. Each assistance unit member must meet the following non-financial criteria:

1. Age (minor child and aged only); 2. Minor child living with a specified relative (ACA PCR and Family medically needy only) 3. Social Security Number (SS card is NOT required); 4. Montana residence 5. Citizenship and/or immigration status; 6. Identity (must be documented for all applicants and recipients) 7. May need to meet blind/disabled criteria (ABD only); 8. Level of care (ABD only) 9. Community engagement requirements as applies to ACA Adult Medicaid and ACA Adult (see CMA 310-1 Community Engagement and Exclusion Policy)

In addition, the applicant/child's parent/caretaker must cooperate with:

1. Primary Care Case Management (PASSPORT provider) 2. Program Compliance with Medicaid reviews; and 3. Third Party Liability (TPL) including