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

MA-200

DEFINITIONS

REVISED 03/01/11 – CHANGE NO. 03-11 (III.) Lump Sum Payment --- Money received with no anticipated recurrence.

Maintenance Allowance --- Amount an individual or family group is allowed for basic needs or maintenance.

Manual Notices --- In certain situations the IMC must complete and mail the appropriate notice informing the a/r of changes or adverse actions to be taken in his case.

Mass Revisions (Changes) --- Certain changes that are initiated by the State or Federal government that may affect the entire caseload or significant portions of the caseload.

Means Tested Program --- An assistance program in which an applicant's financial circumstances are considered.

Medicaid Certified --- Enrolled in the North Carolina Medicaid program.

Medicaid Couple --- An MAABD/MQB Medicaid a/r who is married and living with a spouse who is applying for or receiving MAABD/MQB Medicaid.

Medicaid Family Planning Waiver (FPW) --- A program for men age 19 through 60 and women age 19 through 55, with income at or below 185% of the federal poverty level, to receive family planning services.

Medicaid Individual --- A Medicaid a/r who is single or who is married to a WFFA or SSI Recipient.

Medicaid Ineligible Spouse --- An individual not receiving MAABD/MQB Medicaid who is married to and living with a spouse who receives MAABD/MQB Medicaid and who is not an WFFA or SSI recipient.

Medicaid Reimbursement Rate --- The rate at which a given facility is reimbursed for a Medicaid recipient in the approved level of care.

Medical Home -- A primary health care doctor’s office.

Medical Institution --- An institution that provides medical care, including nursing and convalescent care, such as a hospital.

Medicare --- A program of health insurance for aged and disabled individuals who meet the program's eligibility requirements. Title XVIII of the Social Security Act.

Medicare Medical Health Savings Account (Medicare Advantage) (MHSA) -- Yearly Medicare deposits into an interest-bearing account to help the plan member cover their health care costs until the deductible is met. The accounts are linked to high deductible health insurance polices. These plan account funds are a countable resource for Medicaid purposes.

Medicare Part D --- A prescription drug program through Medicare that provides all Medicare beneficiaries with prescription drug assistance. The Low Income Subsidy is a part of this program.

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