Terms/Definitions
Program of medical assistance for aged individuals 65 and over.
What is MAA-Medicaid for the Aged?
A Systematic Alien Verification for Entitlements used to verify INS status.
What is SAVE?
Is there a waiting period to establish state residence for Medicaid?
What is No?
A physical or mental impairment which prevents an individual from engaging in any substantial gainful activity, and which has lasted or is expected to last at least 12 months, or is expected to result in death.
What is the SSI definition of Disability?
Supplemental Security Income
What is SSI?
A medical assistance program for low income people. It is run by the Division of Medical Assistance and Department of Health and Human Services.
What is Medicaid?
Individuals that live in the U.S. but are not U.S. Citizens.
What are Aliens?
Case action taken when an A/R moves from one county to another.
What is County Transfer?
The section of the NC Division of Vocational Rehabilitation which is responsible for making determination of disability for RSDI, SSI and Medicaid.
Who is Disability Determination Services (DDS)?
The process by which the State pays the Medicare premiums for Medicaid recipients.
What is the Buy- In?
Covers inpatient hospital stays, Skilled Nursing Care and some in home aide services.
What is Medicare Part A?
U.S Citizenship has to be reverified at recertification?
No
The customer states that they have moved out of state. What action should be taken?
Process for the time that they are in NC then deny the case.
An application taken for an applicant who has not been determined disabled by Disability Determination Services (DDS).
What is MAD 90 application with disability determination?
A specified group of former SSI recipients under categorically needy criteria. Qualified individuals are eligible for a disregard of certain RSDI benefit.
What is Pass-along?
A limited Medicaid program which pays a recipient’s Medicare premiums, deductibles and copayments only.
What is MQB-Q?
Puerto Rico, Guam, Virgin Islands, Northern Mariana Islands, American Samoa, Swains Islands
What are the U. S. territories that constitute U.S. Citizenship?
When an individual lives in his own home or an adult care home.
What is Private Living Arrangement?
What are the forms that are sent to Disability Determination Services for disability determination?
What is DMA 4037, DMA 5009, DMA 5028, Mental Health Release form, if needed.
Individuals who received disability for 24 months, 65 years old and older or individuals who have renal/kidney failure.
What is who is eligible for Medicare?
A Program authorized under Title XVIII of the Social Security Act. It is administered by the CMS (Centers for Medicare and Medicaid Services) in Baltimore, Maryland.
What is Medicare?
How long is the disqualification period for some qualified aliens?
5 years
1. In the event of an accident or the need for emergency medical care arise while in another state
2.DMA determines the needed medical services cannot be provided in NC.
3. If medical procedure is available in a border county.
What are situations in which NC Medicaid will pay for medical expenses incurred outside of the state?
An application taken for an applicant who has been determine disable by DDS.
What is a MAD 90 application without disability determination ?
Covers medically necessary physician’s services, outpatient therapy and speech pathology services. It also covers other medical services such as laboratory X-rays and medical supplies, and home health services when the individual does have part A.
What is Medicare Part B?