ACRONYMS
MAGI
MODIFIED ADJUSTED GROSS INCOME
Benefits are EFFECTIVE DATE OF BIRTH
When MEDI-Cal COVERAGE BEGIN for a NEWBORN?
Not eligible under any other prior category• Age 21 through 64 (through the end of the month in which the individual turns age 65)• NOT determined blind or disabled • NOT receiving institutional or HCBS services• MAGI income no more than 66% FPL
MAGI ADULT
DEFAULT TAX FILING STATUS
NON-FILER
ALL PARENTS LISTED NOT IN THE HOUSEHOLD
ABSENT PARENT RECORD
• Time-limited assistance as a result of an initial, simplified determination of eligibility• Based on individual's self-declaration• Age 19 through 64 (through the end of the month in which the individual turns age 65)• Limited to one presumptive coverage period per 12-month span• MAGI income no more than 138% FPL
PE(PRESUMPTIVE ELIGIBILITY)
RETRO COVERAGE COVERS WHAT?
UP TO 3 MONTHS PRIOR TO APPLICATION MONTH
ADDING PHONE NUMBER AND EMAIL
What is INDIVIDUAL DEMOGRAPHICS?
OUTSIDE OF PHE HOW MANY DAYS FOR MEDICAID RE-INSTATEMENT?
ALL CATEGORIES OF MEDICAID NOW HAVE 90 DAY REINSTATEMENT PERIODS
• Newborn child born to a Medicaid-eligible woman• Child is automatically eligible for Medicaid from the date of his/her birth until age one without consideration of household composition or income• Based on household MAGI income no more than 156% FPL
WHAT IS THE PROCESS CALLED FOR AUTOMATED SYSTEM RENEWALS?
PASSIVE RENEWAL
SELF-EMPLOYMENT DEDUCTIONS
EXPENSE SCREEN
WHEN DID MAGI EXPANSION BEGIN?
1/1/2014
• Not eligible as a MAGI Child, Pregnant Woman, or Parent or under any other prior category• Age 19 or 20 (through the end of the month in which the individual turns age 21)• Receiving HCBS• MAGI income more than 44% FPL to no more than 66% FPL
MAGI COMMUNITY RIBICOFF
HOW LONG IS POSTPARTUM ELIGIBILITY?
12 MONTHS AS OF 4/2022
ADDING RETRO MONTHS
What is CASE SUMMARY UNDER VIEW DETAILS AND EDIT WITH CLIENT NAME?
CALHEERS
What is California health eligibility and enrollment retention system?
SELF DECLARED ELIGIBILITY FACTORS (6)
SOCIAL SECURITY NUMBER, OHIO RESIDENCY, AGE, IDENTITY, TAX STATUS AND PREGNANCY
• MAGI income no more than 109% FPL• Must reside with a dependent child under the age of 18 (through the end of the month in which the child turns age 18)
What is MAGI PARENT/CARETAKER Relative M3/M4
WHO IS SUBJECT TO ESTATE RECOVERY(HINT IT IS 2 GROUPS)
OVER 55 IN RECEIPT OF ANY MEDICAID AND OR INSTITUTIONALIZED/FACILITY(ANY AGE ANY TIME FRAME).
BUDGET RESULTS(ACCEPTED)
EDBC RESULTS