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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 (II.) PACE --- Program of All-inclusive Care for the Elderly. A managed care service delivery for the frail community-dwelling elderly, most of whom are dually eligible for Medicare and Medicaid benefits, and all of whom are certified eligible for nursing home placement according to North Carolina standards.

Pregnancy Medical Home (PMH) -- A managed care service that assists pregnant Medicaid recipients with perinatal care (the period immediately before and after birth) thereby ensuring healthy pregnancies and improving birth outcomes. This will be done by modeling the PMH after the enhanced primary care case management (PCCM) program developed by CCNC.

Special Assistance - (SA)

a. Adult Care Home --- Cash payments and medical assistance for eligible aged, disabled and blind individuals residing in a licensed adult care home facility.

b. Certain Disabled --- Cash payment only for individuals in a private living arrangement who meet the state's definition of disability. (This program is not available in all counties.)

c. In-home --- Cash payments and medical assistance for eligible aged, disabled and blind individuals residing in a private living arrangement who are at risk of placement in an adult care home.

Work First Family Assistance --- A cash payment and Medicaid program for families with children who are low income. This program is known as TANF at the national level.

III. DEFINITIONS

Actuarially Sound – A promissory note, annuity, mortgage or loan established to pay off the entire asset value over the actual or expected lifetime of the annuitant/lender is actuarially sound. The annuitant/lender is expected to live long enough to receive an amount that is equal to or greater than the amount originally invested. The total amount of proceeds must be designed to be paid out in equal amounts during the term of the agreement, with no deferral and no balloon payments.

Annuitant – An annuitant is the person who receives the income payments of an annuity policy at maturity date for life or for a specified period. The annuitant may or may not be the same as the owner.

Annuitize – Converting the principle of an annuity into a series of payments.

Annuity - An annuity is a type of trust. An individual pays an entity a lump sum of money in return for the right to receive fixed, periodic payments, either for life or a term of years. This includes the investment portion of a single premium pure endowment life insurance policy.

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