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Exception: MAF, (IV-E) Foster Care and Adoption and State Foster Care beneficiaries do not require a disability determination.

III. REQUESTING CAP SERVICES

To receive CAP services an applicant/beneficiary (a/b) must meet the Medicaid eligibility requirements in one of the following programs:

• MAABD (Medicaid for the Aged, Blind and Disabled) • MAF (IV-E Foster Care and Adoption and State Foster Care)

• HCWD (Health Coverage for Workers with Disabilities)

A. The a/b requests CAP services.

1. Individual is currently not a Medicaid beneficiary a. A Medicaid application must be submitted. b. Evaluate for Medicaid eligibility in appropriate Medicaid programs.

2. Individual is currently a Medicaid beneficiary a. Process as a change in situation.

b. Evaluate for Medicaid eligibility in appropriate Medicaid programs.

c. If the a/b had a deductible, recalculate the deductible for months in the certification period prior to the CAP authorization.

d. Multiply the monthly private living arrangement (PLA) deductible by the number of months in the certification period prior to CAP eligibility to calculate the new deductible amount.

e. The new deductible amount may change the authorization date of Medicaid eligibility.

f. Any excess expenses previously submitted may be used towards the CAP monthly deductible.

There is no retroactive coverage for CAP services; however, there is retroactive coverage for Medicaid services if eligibility requirements are met in the retroactive period.