Transitional Medical Assistance
What months are Quarterly Report Forms mailed out.
Months 3, 6 and 9.
How many days in advance from the 65th birthday of client does the age change alert generate?
60 days.
What 3 things make an application valid?
1. Name
2. Address
3. Signature
What are the steps to the income hierarchy? (5)
1. IRS/HUB
2. VCI/TALX
3. SEW
4. Paper Verification/PC
5. Send VR
Renewal form is received and nothing is changed with the tax household. What information needs update?
Tax permissions
What type of income must the Parent or Caretaker Relative have?
Earned Income (Employment or Self-Employment)
If a client loses Current Pay SSI due to income or resources, how many months do they have to regain their Current Pay status?
12 months
Application is identified as a duplicate and client is currently pending. What is the next steps?
Deny the client and send a generic notice including comments.
If client is paid weekly, how many paystubs are needed?
4
Initial application: Client is a NTF should the TAX interface be pinged?
No as the client is a NTF, we can no longer use the HUB.
Earnings of a child age 18 and younger, and in school, are included. True or False.
False - Income from a child age 18 or younger and in school must be disregarded.
Client is determined eligible under AABD/QMD. Which month does Buy-In begin?
Month after processing month.
Pending application: Client is denied for over income. Is a new application needed?
Yes as they were denied for eligibility requirement.
Are financial gifts and contributions counted for MAGI?
No - Income is not taxable to the recipient.
Newborn in the case and we are unable to get TFS, how should they be entered?
Own tax HH listed as NTF with no signature date or future years. Staff would send a speed note to the HH with the TIF as the baby is CE.
What type of notice must be given when changing Medicaid category to TMA?
Adequate and Timely Notice.
What determines if a client should be Non-Magi?
Age, Disabled or receiving Medicare.
Application is for a 20 year old. The application is completed by mom who is claiming the 20 year old on taxes. Is the application valid and why?
Yes because they are a part of the same tax household.
When are 3 times we would use actual only as a pay schedule?
1. Retro
2. Terminated Income - Final pay received in month being processed.
3. New income - processing for the month employment started and one paystub is received.
19 year old client was previously being claimed by parents and no longer being claimed. Should the parents income count in the budget?
No - as client is 19 and no longer being claimed.
TMA is ending and you can not verify income. What is the next step?
If income can not be verified at time of TMA ending then income in previous budget would be used to determine ongoing Medicaid.
Reason: Client can not be in TMA longer than 12 months.
What resources is client attestation acceptable for? (4)
1. Direct Express
2. ReliaCard
3. Nursing Home accounts
4. Cash on Hand
Paper application is received in DI on 1/9/2026 but signed for 12/25/2025. What month does the client get pended for?
January as that is the month the application was received by Medicaid.
SEW is reporting 2nd and 3rd quarters for employment with a significant decrease from 2nd to 3rd, renewal form is received not attesting to the employment. Can Reasonable Explanation be used to verify EOE.
Yes - client attested to no longer being employed AND SEW shows significant decrease.
Reminder: VCI can not be used to verify RE.
NCP (Non-Custodial Parent) is claiming a Medicaid participant child. What information is needed to determine income?
Custody agreement. Joint custody, the NCP's income would be included in the budget.