Page 148
Manual Title Chapter Page Revision Date Virginia Medical Assistance Eligibility M03 April 2022 Subchapter Subject Page ending with Page M0330.000 FAMILIES & CHILDREN GROUPS M0330.800 29
F. Enrollment The aid category for BCCPTA individuals is "066".
G. Benefit Package The BCCPTA group is a full-benefit covered group. All Medicaid-covered services are available to BCCPTA enrollees, including long-term care in a facility or in a community-based care waiver. H. Renewal Annual renewal requirements are applicable to the BCCPTA covered group. At the time of the annual renewal, the recipient must provide a statement from a medical provider verifying continued treatment for breast or cervical cancer. The BCCPTA Redetermination (form #032-03-653) is used for the renewal. See M1520.200 for renewal requirements.
M0330.800 FAMILIES & CHILDREN MEDICALLY NEEDY GROUPS
A. Introduction An F&C medically needy individual must • be a child under age 18, or 21, or • meet the adoption assistance, foster care or pregnant woman definition in subchapter M0310. B. Procedure The policy and procedures for determining whether an individual meets an F&C MN covered group are contained in the following sections: • M0330.801 Pregnant Women; • M0330.802 Newborn Children Under Age 1; • M0330.803 Children Under Age 18; • M0330.804 Individuals Under Age 21; • M0330.805 Adoption Assistance Children With Special Needs for Medical or Rehabilitative Care. C. Referral to Health Insurance Marketplace When an individual meets an F&C MN covered group is not eligible solely due to excess income and is placed on a MN spenddown, the individual must be referred to the Health Insurance Marketplace (HIM) so that the applicant’s eligibility for the APTC can be determined. Note: Individuals with Medicare are not referred to the HIM. D. Aid Categories Aid Categories (ACs) are used in the eligibility and enrollment systems to denote coverage groups. Some covered groups have multiple ACs for designating disability status, age, income, and other demographic information. These ACs may be used for reporting and funding purposes. The policy sections for each MN covered group contain the assigned ACs Exception–MN individuals of any age who have been determined to be eligible for Medicaid coverage of emergency services based on the alien status requirement policies in subchapter M0220 will be assigned to AC 113 regardless of their covered group.