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ACA/FAMILY MEDICAID 201-8 ACA Adult Medicaid Supersedes: FMA 201-8 (07/01/2016) Reference: 42 CFR 435.119; ARM 37.82.101, .301, .702, .703; ARM 37.84.101 - .115; SB 405 (MCA 17-7-502) Overview: The Montana Health and Economic Livelihood Partnership (HELP) Act created two new coverage groups beginning January 1, 2016: ACA Adult and ACA Adult Medicaid. This section covers ACA Adult Medicaid; ACA Adult is covered in section ACA-FMA 201-7 ACA Adult ACA Adult Medicaid covers individuals age 19 through 64. Medically frail and Native Americans/Alaskan Natives with income of 51% to 133% FPL are covered under the ACA Adult Medicaid program. FINANCIAL CRITERIA: Income is determined under MAGI rules and must be 0% to 133% FPL (after a 5% disregard). NON-FINANCIAL CRITERIA: Medicaid standard nonfinancial requirements are listed in section CMA 300 Non-Financial Overview. In addition to the standard criteria that applies to all Medicaid programs, the following nonfinancial criteria are specific to ACA Adult Medicaid: · Must be age 19 through 64; · Cannot be eligible for or enrolled in Medicare Parts A and/or B; and · Cannot be pregnant at application. For individuals with income of 51% - 133% FPL, one of the following criteria must also be met: · Are medically frail; or · Are Native American or Alaskan Native FILING UNIT: Required filing unit members are determined based on tax filing rules. See FMA 200-1 ACA Filing Unit for ACA filing unit requirements.