DATE: FEBRUARY 20, 2006
Manual: Family and Children’s Medicaid
Change No: 08-06,Poverty Level Income Limits
To: County Directors of Social Services
Effective: April 1, 2006
The purpose of this change notice is to issue the new poverty level income limits for MPW, MIC, Transitional Medicaid and NC Health Choice for Children (NCHC). This also provides implementation instructions for pending applications, new applications, and ongoing cases.
Income limits for MPW, MIC, NCHC and Transitional Medicaid have been revised to reflect the increase in the federal poverty level. EIS edits were updated effective Friday, February 24, 2006. The new income limits can now be entered into EIS.
Cases keyed with a Medicaid effective date of 4/01/06 or later must use the new income limits in EIS.
If eligible using the new income limits and all other eligibility factors are met, approve the application and authorize effective 04/01/06. Authorizethrough the end of the 60 day post-partum period. Refer to MA-3310,MPW Budgeting. Evaluate months prior to 04/01/06 in other Medicaidaid program/categories.
Always evaluate for eligibility under any other aid/program category (including MAF-M) prior to evaluating for NCHC.
Enter the new income limits in EIS if the Medicaid effective date is 04/01/06 or later.
Note: Administrative applications, which are entered to authorize MIC, NCHC, or MPW coverage, do not count in the average processing time for application processing standards.
For MAF applications pending with a deductible or for reserve verifications, evaluate eligibility effective 04/01/06 using the new income limits. For individuals ages 0-5, evaluate for MIC-N or MIC-1. For individuals ages 6-18, evaluate for MIC-N and NCHC.
Apply these changes at the next redetermination to determine eligibility for MIC-N, MIC-1, NCHC or MPW if the case is ineligible for MAF or has a deductible.
Apply these changes at the next redetermination. If the Medicaid Effective Date is prior to April 1, 2006, use the old limits. See MA-3305, MAF, MIC, HSF Budgeting, for instructions regarding changes that affect MIC.
Use the new 185% poverty limit for Transitional Medicaid for months beginning April 1, 2006.
L. Allen Dobson, Jr., M.D., Assistant Secretary for Health Policy and Medical Assistance
(This material was researched and written by Trenita Dawkins, Medicaid Policy Consultant, Medicaid Eligibility Unit.)
For questions or clarification on any of the policy contained in these manuals, please contact your local county office.