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MEDICAL MEDICAL MEDICAL MEDICAL MEDICAL MEDICAL MEDICAL MEDICAL MEDICAL MEDICAL MEDICAL MEDICAL ASSISTANCE OVERVIEW A-100 PURPOSE AND APPLICABILITY The Medical Assistance Manual incorporates eligibility policy for all medical assistance programs including family medical groups, children’s groups, specialized households, Nevada Check Up and Medical Assistance to Aged, Blind and Disabled (MAABD) groups. Exceptions to medical assistance policies are noted in each chapter; otherwise the policy is applicable to all medical assistance programs. A-105 MEDICAL ASSISTANCE OVERVIEW The Affordable Care Act (ACA) requires all individuals to maintain minimal essential health coverage beginning January 1, 2014. Individuals who do not maintain minimal essential health coverage (MEHC) may face tax penalties for noncompliance. (MEHC) includes Medicaid, Medicare, government- sponsored programs, employer-sponsored health plans, and private insurance plans offered through a state’s health insurance exchange. Certain individuals may be excluded from the individual responsibility requirement. Individuals with religious objections, individuals not lawfully present in the U.S., and incarcerated individuals are excluded from the individual responsibility requirement. In addition, an exemption from the tax penalty is available for any individual who:  Has coverage available that is considered cost prohibitive because their required contribution for coverage exceeds 9.5% of the annual household income;  Has a household income of less than 100% of the Federal Poverty Level (FPL);  Is a member of an Indian Tribe and eligible for services through an Indian health care provider;  Has been without minimum essential coverage for less than three months; or  Has obtained a hardship waiver from HHS because, for example, there is no affordable qualified health plan available to the individual through his or her employer or an exchange. The ACA allows states to expand Medicaid to cover low-income adults and children with income up to 138% of the FPL. In addition, individuals and families who have income above the Medicaid level but below 400% of the FPL will receive tax credits to help them purchase coverage in the new health insurance exchange. People with income up to 250% of the FPL, receiving premium credits, will also get additional assistance with their cost-sharing charges. A-100 Division of Welfare and Supportive Services MEDICAL ASSISTANCE OVERVIEW Medical Assistance Manual PURPOSE & APPLICABILITY – MEDICAL ASSISTANCE OVERVIEW 24 Sept MTL 07/24