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North Carolina Department of Health and Human Services AGED, BLIND, AND DISABLED MEDICAID MANUAL

MA-200

DEFINITIONS

12 REISSUED 03/01/11 – CHANGE NO. 03-11 (III.) Brown Lung Benefits --- Payments made to persons disabled by lung disease resulting from exposure to raw cotton dust.

Budget Unit --- Persons whose income and resources are considered in the determination of eligibility for an individual or family group.

Caretaker Relative --- The natural or adoptive parent or the specified relative living in the household with the child who is eligible for Medicaid and providing the child's day-to-day care and supervision.

Carolina Access --- A program to link Medicaid recipients with a primary care provider who agrees to provide or arrange most of the enrollee's health care services.

Case ID Number --- A unique computer-assigned identification number.

Case Number --- A number assigned to a case by a county department of social services.

Case Record --- A file containing the application and all documents verifying initial and continuing eligibility for members of the assistance unit.

Casehead/Payee --- The person to whom the benefits are written.

Categorically Needy – SSI Recipient -- Medicaid classification for individuals receiving SSI who are automatically eligible for Medicaid. Classification will always be C or Q (if Medicare). The aid program/category is MAD, MAA, SAA, SAD, AAF payment type 5 or HSF.

Categorically Needy – Non SSI Recipient --- Medicaid classification for Work First coverage groups and for Medicaid cases with caretaker relatives and/or children under 21 who meet the categorically needy income and, if applicable, asset requirements. Classification is C or N. Work First cases must be classified C. Individuals age 19 and 20 who are not caretakers of a child and independently living children under 19 who are not otherwise eligible for MIC must be evaluated for MAF-N. Individuals determined eligible under a poverty coverage group must be N (either MIC or MPW). Caretaker relatives and other children under 19 who meet categorically needy requirements are classified C.

Certification period --- The period of time for which assistance is requested and in which all eligibility factors except need and reserve (when applicable) must be met.

Change in Situation --- A change in a recipient's circumstances that may affect eligibility for assistance.

Child Support --- Money or in-kind goods given for a child by a parent for the child's care.