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case closed/became medically needy due to a new or increased earned income to the household; AND 2. At least one qualifying child remains in the household, and 3. Not be eligible for any other type of Medicaid assistance.

Upon ACA PCR, ACA Adult, and ACA Adult Medicaid closing/becoming medically needy due to a qualifying event, notify the family via appropriate system notice of TMA eligibility. CONTINUING COVERAGE: TMA coverage continues for 6 consecutive months as long as: 1. There is a qualifying child in the home; 2. The family maintains Montana residency; 3. The parent/specified caretaker relative cooperates with: a. Program Compliance Medicaid reviews and b. TPL (HIPPS, Trauma Questionnaires, providing health insurance information and insurance questionnaires). If the parent/specified caretaker relative fails to cooperate with program compliance or TPL; they will be disqualified by entering appropriate data on either the ‘Person Compliance’ or ‘Health Coverage Compliance’ Web page. The children’s Medicaid is not closed due to the parent/specified caretaker relative’s failure to cooperate. NOTE: If income decreases significantly during the TMA eligibility period, it is good customer service to notify the family of potential ACA Medicaid coverage. This could allow for an additional TMA period should income increase again. CHIMES will automatically test for this coverage. and 4. Reporting requirements are met. EXAMPLES (QUALIFYING EVENT): 1. A family starts receiving unearned income that causes their ACA PCR, ACA Adult, and ACA Adult Medicaid case to become medically needy. As this was the result of new or increased unearned income, this is not a qualifying event and the family is not eligible for TMA. 2. Household consists of mom, mom’s two children, and mom’s boyfriend (not father of the children). The household does not include the boyfriend. Mom and boyfriend get married; his income causes mom’s ACA Medicaid case to become medically needy/close. The is no TMA eligibility for any household member as the closure was not due to a qualifying event. Closure was due to adding the boyfriend (now the spouse) and subsequently counting his income. CHIMES will automatically test eligibility for children under other programs through an ex parte review. 3. Household consists of mom and her child. The absent father returns to the home. When he is added to the case, his income causes closure. No household