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DMA ADMINISTRATIVE LETTER NO: 11-13, ADDENDUM 1, Hospital Provider Instructions for Determining Presumptive Eligibility

DATE:

March 31, 2016

SUBJECT:

Hospital Provider Instructions for Determining Presumptive Eligibility

DISTRIBUTION:

Enrolled Presumptive Eligibility Hospitals

County Directors of Social Services

Medicaid Eligibility Staff

I. background

II. instructions

If you have any questions regarding this information, please contact the Operational Support Team at ost.policy.questions@dhhs.nc.gov.

Sincerely,

 

 

Dave Richard

Deputy Secretary for Medical Assistance

(This material was researched and written by Ena Lightbourne, Policy Coordinator, Medicaid Eligibility Unit).

MAGI MEDICAID INCOME LIMITS

***MAGI groups do not have Reserve Limits - Only MAF-M group***

Revised effective 4/1/2016

Family & Children’s MA

1

2

3

4

5

6

7

8

9

10

Add’l

196% MPW

1941

2617

3293

3969

4646

5322

6000

6679

7359

8038

680

195% MAF-D

1931

2604

3276

3949

4622

5295

5969

6645

7321

7997

676

194%-210% MIC-1<1

1921.01-2079

2590.01-2804

3260.01-3528

3929.01-4253

4598.01-4977

5268.01-5702

5939.01-6428

6611.01-7156

7284.01-7884

7956.01-8612

728

194% MIC-N <1

1921

2590

3260

3929

4598

5268

5939

6611

7284

7956

673

141%-210% MIC-1(Age 1-5)

1396.01-2079

1883.01-2804

2369.01-3528

2856.01-4253

3342.01-4977

3829.01-5702

4316.01-6428

4805.01-7156

5294.01-7884

5783.01-8612

7284

141% MIC-N (Age 1-5)

1396

1883

2369

2856

3342

3829

4316

4805

5294

5783

489

107%-133% MIC-1(Age 6-18)

1060.01-1317

1429.01-1776

1798.01-2235

2167.01-2694

2536.01-3153

2906.01-3611

3276.01-4071

3647.01-4532

4017.01-4994

4388.01-5455

462

107% MIC-N (Age 6-18)

1060

1429

1798

2167

2536

2906

3276

3647

4017

4388

371

MAF-C/N

434

569

667

744

824

901

975

1036

1096

1169

78

185% TMA

1832

2470

3108

3747

4385

5023

5663

6304

6946

7587

642

NC Health Choice

1

2

3

4

5

6

7

8

9

10

 

133%-159% MIC-J (Age 6-18)

1317.01-1575

1776.01-2123

2235.01-2672

2694.01-3220

3153.01-3769

3611.01-4317

4071.01-4867

4532.01-5418

4994.01-5970

5455.01-6521

552

>159%-211% MIC-K (Age 6-18)

1575.01-2089

2123.01-2817

2672.01-3545

3220.01-4273

3769.01-5001

4317.01-5729

4867.01-6459

5418.01-7190

5970.01-7922

6521.01-8653

732

 

 

 

 

 

 

 

 

 

 

 

 

                       

MAGI disregard

1

2

3

4

5

6

7

8

9

10

Add’l

FPL 5% DISREGARD

49.50

66.75

84.00

101.25

118.50

135.75

153.04

170.38

187.71

205.04

17.33

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