Definitions
What is the income limit for HIP?
133% FPL plus a 5% disregard/ 133% FLP minus 5% of the income
How long are clients under condition status?
60 days
What age would place an individual in MA A category?
65+
What is the General Income Disregard.
$20.0
What are the 4 MCE's for HIP?
Anthem Blue Cross Blue Shield, Care Source, MDwise, and MHS
MCE stands for this:
Managed Care Entity
Who is responsible for collecting the PAC payments?
Insurance company
Can an applicant/recipient receiving MASI have mandatory non-participating members in their AG?
NO
IEDSS includes these types of income in the budget of the participating and non-participating members in MED 4 eligibility.
Earned and Unearned income
This is the category of children's health insurance that falls at 250% FPL and required a monthly premium.
CHIP/ Children's Health Insurance Program.
What is PAC?
Power Account Contributions.
Where in IEDSS will you locate existing Hip pays or no pays?
Others, interfaces, Hip pay/ no pay.
If an individual is disabled and receiving Room and Board assistance, what category of Medicaid would they receive?
MA R
This MED 4 category of coverage pays the full Medicare Part B premium, the Medicare Part A premium, and the Medicare Part A and B deductibles and co-insurance
MA L
According to policy site 3220.15.00, this is who can be counted in the assistance group of pregnant women.
The unborn child/children.
What is Deemed income?
Non-recipient AG members’ income that is included in the eligibility determination.
What is a Fast Track Payment?
A $10 payment applicants may pay while filing an online application or anytime prior to authorization of HIP
What is criteria for individual to receive MA B?
Individual must meet the definition of blindness set forth in state regulation. The definition is the same as the SSI program. (Blind)
DAILY DOUBLE:
Besides the applicant, these are the individuals included in a MED 4 budget:
The spouse of the applicant/recipient who lives together, unless on an HCBS waiver, the applicant/recipient's biological, adoptive, and step children under the age of 18, applicant/recipient's children between ages 18-21 who are students and live in the home, the applicant/recipient's essential person.
This is the amount of a life insurance policy that is exempt from MED 1 and MED 4 budgets.
$1500
The amount of money that is deducted from the gross income and set aside for dependent children or essential persons that live with the applicant/recipient.
DAILY DOUBLE
What happens when a client does not pay their PAC payment within 60 days?
If they have income equal or lesser than 100% FPL and they did not pay their PAC then Basic Coverage begins. If they were already on basic, then they stay on basic.
What is the Resource limit for a single individual receiving MASI?
NA- there is no resource limit for MASI.
According to policy site 2005.05.15, these are the exceptions to the interview process for a MED 1 or MED 4 application:
• LIS/MSP applications sent electronically to the eligibility system via data exchange from SSA
• SSI recipients
• SSI recipients that are adding a Medicare buy in category, such as MA L
What percentage of a jointly owned resource do spouses own?
50%