Cert & Auth Periods
The two types of certification periods.
What is Retroactive and Prospective (Ongoing)
This is who pays the Medicare premiums for Medicaid recipients on the Buy-in.
Who is the State?
This part of Medicare commonly has a monthly premium.
What is Medicare part B
CAP is administered by these 2 entities
What is the County Health Department and other Local Management Entities
All aid program/categories allow retroactive coverage except
What is MQB-Q?
This period is the time that the A/R is actually receiving Medicaid coverage.
What is Authorization period?
This is who pays the Part A premium for individuals eligible for MQB-Q, MAABD and SA if their class is "Q" and their Medicare claim number ends in "M".
Who is Medicaid?
Medicare cost shares in these programs
What is MQB programs
The client must already receive this benefit to be involved in CAP.
What is Medicaid
This class can only have 6 months c.p.
What is M class?
This is the CP & AP for Client who is 25, applies on 6/5/2025 and requested retro.
Receives $1005/mo RSDI
$700 in a checking account
No Medicare
What is reto CP & AP: 3/1/2025 - 5/31/2025
What is ongoing CP & AP: 6/1/2025 - 5/31/2026
These 2 classes does not participate with FFP.
What is N and M class?
A client is 64 years old and has been receiving Social Security retirement since she turned 62. This is the age the client is eligible for Medicare.
When is age 65?
The eligibility Specialist must accept and work the medical assistance application when CAP is requested and notify this department who handles all CAP applications.
What is LTC (Long Term Care)
This is the program and class for the below client:
Age 45, applies on 5/15/25
income: $1300 Wages
$1700 revocable burial contract, Bank acct $25K, No Medicare
What is HCWD-N?
This is the auth period for client who is aged, receives Medicare, applies on 2/15/25.
Receives $1300/mo RSDI
$5500 reserves
Reduces reserves to $1950 on 2/26/2025
What is auth period of 3/1/2025 - 1/31/2026
This is the buy-in date for a client who is 53 yrs old, applies on 2/14/25, wants full Medicaid. Receives $1565/mo RSDI
$1200 reserves, has Medicare
Met deductible on 4/5/2025
What is the buy-in date of 6/1/2025
This client is eligible for Medicare on this date:
Client is 36 and has been receiving SS disability since 11/2023.
When is 11/2025
Cap provides these 3 types of services for CAP eligible applicants.
What is Medical and non-medical home and community-based services
This is the program and class for the below client:
Age 64 (DOB 8/31/2025) applies on 7/20/25
Not disabled. Medicare entitlement date: 8/2025
Income: $1400 RSDI & $150 pension monthly
Vehicle valued $1500 and $375 checking acct
What is MAA-B
This is the Cert & Auth period for Client who is disabled & applies on 3/10/25. Has Medicare A&B.
Receives $2001/mo RSDI
$1040 in checking
Met deductible on 4/3/2025
What is CP: 3/1/2025 - 8/31/2025
and what is AP: 4/3/2025 - 8/31/2025
This is the Buy-in date for client who is aged, receives Medicare, applies on 2/15/25.
Receives $1279/mo RSDI
$6000 reserves
Reduces reserves to $1999 on 3/16/2025
What is Buy-in date of 4/1/2025
These 2 circumstances must be met prior to an Alien being eligible for Medicare.
What is the 5 year bar and be at least 65 years f age.
CAP abbreviation stands for this and was created with this main objective/goal.
This is the program and class for the below client:
Client applied on 9/1/25 for Medicaid
What is MQB-E