MEDICAID 101
A client calls and states they are receiving Medicare and Medicaid. What is this considered?
What is Dual Eligible?
I am completing an exparte and I find that a client is currently receiving Medicare Part A and Part B this means that the client is ineligible for this program.
During exparte I find that a client has a TPI. I need to complete this form so that the clients TPI will show in this place.
What is HMS form and NC Tracks
What two questions should I always ask when determining the HH size?
Are you a tax filer?
Will you be claimed as a tax dependent by someone else?
A client is up for recert in July of 2024. In what month should the exparte be completed?
True or False: Medicaid is a federal entitlement program
What is False: Medicaid is a Federal and State program to assist families under the FPL
I am 19 years old and I am a non-filer with no income. What program will I receive?
What is MAFN
I am starting an exparte on a client and in online data they Verify as V and B. However, FNS just ran save on the client the day before you work on the case. True or False: I do not have to run save again to verify clients citizenship
False: SAVE needs to ran at every recert if the client does not verify V and A
Mom (35) children (6) and (7) they all reside with Grandmother. Grandmother is a TF claiming both children. Mom is a Non-Filer. What is each persons HH Comp.
Grandmother-3
Mom-3
Both children- 3
After keying a recertification or a denied recert I must accept the hold either ______ or _______. Once I accept the hold it will generate this notice for eligibility _____.
What is adequate or timely.
What is an 8110 notice.
A client calls the agency stating they are receiving Family and Children’s Medicaid but would like to be evaluated for Adult Medicaid. These programs are considered as the two ______ of Medicaid.
What are the two categories of Medicaid?
During an exparte I have a client that is 65yo. We see no Medicare, SSA benefits, or income in the online data. The client is only eligible for what program under F&C?
What is FPP/MAFD
During my research I could not verify the client’s citizenship. I send out a 5097 requesting proof of citizenship. I can accept these documents as proof of citizenship?
What is:
SSN Card, Birth Certificate, Naturalization Card, Green Card, Alien Number
Uncle (45) employed earning $1750/mo nephew (20) earning survivors benefits of $325 and niece also receiving survivors benefits of $325. Whose income will count for who?
Every persons income will count for themselves.
Uncle- $1750
Nephew-$325
Niece-$325
You terminated a client on 8/31/2024. The client returned their information on 10/18/2024. True or False: the client is over the 90 day reopen period and will need to reapply
False: the clients 90 day period would be 11/29/2024
You receive a phone call from a client and she ask how could she apply for Medicaid. You tell her that she can apply by ______________.
What is:
Online/Epass
Mail/Email
Over the phone/ In the agency
A client calls and states that their income has increased. The client has received MAFC for 3 out of 6 months. The client may be eligible for this program
What is TMA/Transitional
Name 3 post eligibility items. Which post eligibility items are waived during the CCU?
What is Child Support, UIB, RSDI, TPI/TPR, VA Benefits.
What is Child Support and UIB
During exparte I see that a client reported on an FNS application that they have self-employment. True or False: I can use the clients attestation for their self employment and continue to key the case.
During research I notice that a 20020 will need to be sent out to the client. I will also send out a 5097 with the 20020 requesting the client to sign, complete and return the 20020. How many days does the client have to return the requested information?
what is 30 days?
When evaluating for Medicaid there are two types of classification’s: ____________ and ___________
What is Categorically needy and Medically Needy
The client is over income for all programs. So we must request them to meet a deductible for the client to be eligible for _________
What is MAFM
I am completing a recert on a client. Her husband is in the home with her but he is not applying for benefits. When I ran the online data for the both of them his results came back as "insufficient data" meaning he has no SSN. True or False: I need to send him a 5097 requesting his SSN or proof of citizenship?
What is False? Since he is not applying we do not need to verify his C/I
I am completing an exparte for a December review. I see that the client has previous income at Walmart listed on the Insurance Affordability. I run the online data and I find that the client is still employed with Walmart as of Q2 2024 but also has a new hire hit for Sports Endeavors on 7/13/2024. What action should I take?
What is send a 20020/5097 requesting wages?
I am completing an exparte and I see at the previous recert there was a HH of 2 a mom and her son. The mother was previously employed at last recert and she was a tf claiming her son. At this recert during exparte you find that the son is now employed as well. Will a 20020 be sent out to the client? Why or why not?
Yes to verify clients tf status