Page 12

2. Eligibility Across Pathways – Eligibility specialists and application assisters must be available to provide applicants and beneficiaries with information about the impact the limits above have on the choice of eligibility pathways. Such information is also provided with paper applications and built into the self-service portal to assist applicants and beneficiaries in making informed choices about their Medicaid health options. The table below summarizes the major cross pathway eligibility opportunities by major Medicaid populations. Selected Eligibility Cross Pathways By Population (Excludes beneficiaries eligible on basis of other programs) Population MACC Group – MAGI-Based (No Retroactive Coverage) IHCC Group SSI methodology- based (Retroactive Coverage Possible) Both MACC and IHCC Eligibility determined using both Children Up to MACC income limit (261% of FPL + 5% disregard) MN only if income above MACC limit and have high health expenses Family income above MACC limit and meeting institutional level of care – Katie Beckett eligibility based on child’s income only

Not Applicable Pregnant People Up to MACC income limit (253% of FPL + 5% disregard) EAD or MN if disabled, but only until next renewal or birth of baby, Option for MACC and MPPP if have Medicare