ADDENDUM - 2

APAAdult Public Assistance Related Medicaid Subtypes, Eligibility Codes, and Waiver Codes

 

Medicaid Subtype

Description

AS

Waivered Assisted Living

BB

Individual lost SSISupplemental Security Income /APAAdult Public Assistance eligibility from 1977 SSASocial Security Administration COLACost of Living Allowance "Pickle Person"

BC

Breast and Cervical Cancer (Ladies First)

BE

Disability exams (blindness), with or without need for HCBHome and Community-Based Waiver Determination. Non-standard coupon.

DC

Under 18, Receiving SSISupplemental Security Income      

DE

Applicant who requires an ADAid to the Disabled-2, and, if needed, an HCBHome and Community-Based Waiver Determination.

DK

Disabled Kid (TEFRATax Equity and Fiscal Responsibility Act, P.L. 97-248)

DW

Working Disabled Medicaid Buy-In

GF

Individuals eligible for State APAAdult Public Assistance cash program(s) in December 1973

IL

Emergency Alien (AD, AB, and OA) – legal alien or ineligible non-immigrant

IN

Long Term Care  (Nursing Home or HCBHome and Community-Based Waiver)

IP

Residential Psychiatric Treatment Center Waiver

NHNursing Home

Nursing Home  (eligible for SSISupplemental Security Income or APAAdult Public Assistance if not institutionalized)

NS

Ineligible for SSISupplemental Security Income /APAAdult Public Assistance because of requirements which do not apply to Medicaid (use for SSISupplemental Security Income eligible individuals who have not applied for SSISupplemental Security Income )

PM

Section 1619(b) eligible individuals.  See Manual Section 530-E ;or

Disabled Adult Children; or

Disabled Widowers who have lost SSISupplemental Security Income or APAAdult Public Assistance due solely to receipt of title II benefits

QD

Qualified Disabled and Working Individuals (QDWIQualified Disabled and Working Individuals)

QM

Qualified Medicare Beneficiaries (QMBQualified Medicare Beneficiaries)

RC

Eligible for but refusing APAAdult Public Assistance cash payments or has countable income above the APA need/payment standard but below the Expanded Refused Cash Income Limits outlined in ADLTC MS 530(C)

SA

Ineligible for SSISupplemental Security Income /APAAdult Public Assistance because of alien sponsor deeming

SI

Receiving SSISupplemental Security Income

SL

Specified Low Income Medicare Beneficiary.  

(SLMBSpecified Low Income Medicare Beneficiaries)

SS

Individuals eligible for SSISupplemental Security Income or state supplemental payments except for the 20% Social Security Benefit increase (OASDIOld Age, Survivors, and Disability Insurance (Social Security)I ) in 1972.

ST

Not receiving SSISupplemental Security Income

UL

Emergency Alien (AD, AB, or OA) – undocumented illegal alien only

WD

Waiver applicant who does not require a disability determination, but does need a waiver determination.  

Eligibility is for the cost of a Waiver Agency's assessment for Waiver eligibility.  Non-standard coupon.

 

 

 

Incarceration Medicaid

Subtype

Description

AI

APA Related (AD, AB & OA)

BI

Breast and Cervical Cancer

II

Emergency Alien (AD, AB & OA) – legal alien or ineligible non-immigrant

IU

Emergency Alien (AD, AB, or OA) – undocumented illegal alien only

KI

Pregnant Woman

 

 

The following Medicaid eligibility codes are specific to ADLTC Medicaid unless here is a "*" in the description.

 

Medicaid Eligibility Code

Description

11

Pregnant Woman *

19

Waiver Determination Only

20

No other eligibility codes apply *

24

LTC (300%) Institutionalized

25

Disability/Blind/Waiver Determination

30

Adults with Physical and Developmental Disabilities Waiver – Special LTC

31

Adults with Physical and Developmental Disabilities Waiver *

34

Adults with Physical and Developmental Disabilities – APA/QMB eligible

40

Alaskans Living Independently Waiver – Special LTC

41

Alaskans Living Independently Waiver *

44

Alaskans Living Independently Waiver – APA/QMB eligible

53

Ineligible Alien Emergency coverage (used for everyone except pregnant women) *

54

SSI disabled child

66

Medicare Savings Program – QDWI only

67

Medicare Savings Program – QMB only

68

Medicare Savings Program – SLMB only

69

Medicare Savings Program – Dual Medicaid/QMB

70

Intellectual and Developmental Disabilities Waiver – Special LTC

71

Intellectual and Developmental Disability Waiver *

74

Intellectual and Developmental Disabilities Waiver – Dual Medicaid/QMB

78

Medicare Savings Program – SLMB Plus only

80

Complex Medical Condition Waiver – Special LTC

81

Complex Medical Condition Waiver *

91

Individualized Supports Waiver – Special LTC

92

Individualized Supports Waiver *

93

Individualized Supports Waiver – Pregnant*

94

Individualized Supports Waiver – Dual Medicaid/QMB

 

 

Waiver Codes

Description

MC

Complex Medical Condition

MD

Intellectual and Developmental Disabilities

DA

Adults with Physical and Developmental Disabilities

AG

Alaskans Living Independently

IS

Individualized Supports

 

 

 

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