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MRG UPDATED: JANUARY 2012 97 CATEGORICAL FACTORS MEDICAID EXTENSIONS/CONTINUATIONS TRANSITIONAL MEDICAID (TMA) Policy: In order to assist families in making the transition from Medicaid under the Low Income Families (LIF) category of assistance to self- sufficiency as a result of employment, a twelve (12) month extension of Medicaid benefits is mandated under certain circumstances. Twelve (12) months of Transitional Medicaid (TMA) is available if the household: (1) is ineligible under LIF due to new or increased earned income of the parent/caretaker relative, or the loss of an income related disregard; (2) includes a dependent child (under age 21) living in the household; and (3) was receiving Medicaid under LIF in one out of the last six (6) months prior to the termination of eligibility. Earnings may be in combination with unearned income. When the household's income consists solely of unearned income, the household is not eligible for TMA. There is no requirement for continued employment during the TMA authorization period. NOTE: Members of a household may be eligible for TMA when the parent/caretaker relative is not in receipt of Medicaid under the LIF category of assistance, if all other TMA criteria are met. For example: A mother receives SSI cash assistance and has Medicaid. Her two children receive Medicaid under LIF in a separate case. When she becomes employed, she loses her eligibility for SSI. When the new, earned income is counted, the family becomes ineligible for Medicaid under LIF. However, the children meet the TMA criteria and are authorized for the twelve month TMA extension. The mother’s eligibility for Medicaid is determined applying appropriate rules. References: SSL Sect. 366 Dept. Reg. 360-3.3(c) 369.1 385.14(d) ADMs 11 OHIP ADM-05 OMM/ADM 97-2 90 ADM-30 GIS 09 MA/023