Family Healthcare (FAMIS) Manual – Table of Contents

0910.050.00 ELIGIBILITY FOR OTHER MC+ PROGRAMS WHEN TMA ENDS

IM-54 June 2, 2005IM-59 April 24, 2003IM-170  December 16, 2002IM-46  March 2, 2001

An ex parte review must be completed to explore eligibility for other MC+/Medicaid programs when Transitional Medical Assistance eligibility ends.

  1. If Transitional Medical Assistance eligibility terminates at end of the first six months for non-receipt of the quarterly report, determine if any individual on the case is eligible for MC+ as a child or pregnant woman, or for another Medicaid category. The system will automatically convert the children on the case to MC+ for children Non-CHIP coverage.
  2. If Transitional Medical Assistance eligibility is suspended in the second six months for non-receipt of the quarterly report, determine if any individual on the case is eligible for MC+ as a child or pregnant woman, or for another Medicaid category. Children (including parents under age 19) on the case will not be suspended.
  3. When Transitional Medical Assistance eligibility terminates at end of twelve months, determine if any individual on the case is eligible for MC+ as a child or pregnant woman, or for another Medicaid category. The system will automatically convert the children on the case to MC+ for children Non-CHIP coverage.

NOTE: Women becoming pregnant while receiving TMA are not eligible to receive continuous MC+. If the caretaker in a case that loses eligibility for Transitional Medical Assistance is a pregnant woman register a MC+ for Pregnant Women application and process using normal eligibility criteria.