0000009557 00000 n Minor Consent Program. An IE person may only use medical expenses to meet the SOC for other family members associated within the same case.

OBRA Not PRUCOL Long Term Care (LTC) services. 200 Percent FPL Pregnant (Income Disregard Program Pregnant). CMSP Companion Aid Code. For more information about Long Term Care (LTC) services, refer to the County Medical Services Program (CMSP) section in this manual. For more information about LTC services, refer to the OBRA and IRCA section in this manual. [CDATA[ Special Share of Cost (SOC) Case Indicators:These indicators, which appear on a recipients SOC Case Summary Form, are used to identify the following: IE Ineligible:A person who is ineligible for Medi-Cal benefits in the case. <>/ExtGState<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/Annots[ 16 0 R 63 0 R 64 0 R 70 0 R 71 0 R 72 0 R 73 0 R] /MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> Out-of-State Adoption Assistance Program (AAP). Covers medically indigent adults aged 21 and over but under 65 years that meet the eligibility requirements of medically indigent. //]]>. Covers children receiving federal AAP cash subsidies from out of state. This coverage begins on the last day of pregnancy and ends the last day of the month in which the 60th day occurs. QP issues paper PE ID Card. Persons placed in 7G have pregnancy test results that are positive. A recipient may have more than one aid code, and may be eligible for multiple programs and services. Covers children receiving federal cash grants under Title IV-E to facilitate the adoption of hard-to-place children who would require permanent foster care placement without such assistance. MI Adult. Disabled Adult Child(ren) (DAC) Disabled. Craig v. Bonta Disabled Pending SB 87 redetermination. [CDATA[ Cervical cancer-related services covered for 24 months. Covers juvenile probation cases placed in foster care. Healthy Families Child. Covers children on whose behalffinancial assistance is provided for state only foster care placement. Craig v. Bonta Aged Pending SB 87 Redetermination. 0000004658 00000 n Provides full-scope benefits to children up to 3 months of age who were voluntarily surrendered within 72 hours of birth pursuant to the Safe Arms for Newborns Act. Persons placed in 7F have pregnancy test results that are negative. Breast cancer-related services covered for 18 months. 1 0 obj Minor Consent Program. 0000000974 00000 n <>/Metadata 4145 0 R/ViewerPreferences 4146 0 R>> AFDC 1931(b) Non CalWORKS. Provides payment of premiums, co-payments, deductibles and coverage for non-covered cancer-related services for eligible all-age males and females, including undocumented aliens, who have been diagnosed with breast and/or cervical cancer, if premiums, co-payments and deductibles are greater than $750. Providers NOTE:Long Term Care services refers to both those services included in the per diem base rate of the LTC provider, and those medically necessary services required as part of the patients day-to-day plan of care in the LTC facility (for example, pharmacy, support surfaces and therapies). The infant's enrollment in the HF program is based on their mother's participation in AIM. 0000020726 00000 n Covers eligible undocumented aliens in LTC who are not PRUCOL. Provides temporary AE for full-scope, no Share of Cost (SOC) Medi-Cal for eligible females younger than 65 years of age who have been diagnosed with breast and/or cervical cancer. Covers eligible pregnant minors under the age of 21. GHPP-eligible.

100 Excess Property Child. Covers eligible minors at least 12 years of age and under the age of 21.

BCCTP AE. 0000010977 00000 n Valid only for TB-related outpatient services. Restricted Federal Poverty Level Aged. Covers eligible refugees and entrants who are not eligible for Medi-Cal or Healthy Families and do not qualify for or want cash assistance. OBRA/Out of CountyCare. Medi-Cal ID card issued. Restricted to pregnancy and emergency services. Restricted to CMSP emergency services only. Provides eligibility for CEC if for some reason the child is no longer eligible under foster care prior to his/her eighteenth birthday. Covers eligible pregnant alien women who do not have satisfactory immigration status. Covers medically indigent adults aged 21 and over but under 65 years that meet the eligibility requirements of medically indigent and have a pending Medi-Cal disability application. Department of Developmental Services (DDS) Waivers (No SOC). State-funded cancer treatment services are NOTE:Unless stated otherwise, these aid codes cover United States citizens, United States Nationals, and immigrants in a satisfactory immigration status. They may continue to be eligible for all postpartum services and family planning. Provides for the pre-enrollment of children into the Medi-Cal program who are screened as probable for Medi-Cal eligibility. HF covers medical, dental and vision services to enrolled children. TB-infected for TB-related outpatient services only. Provides four months of emergency services for aliens without satisfactory immigration status who are no longer eligible for Section 1931(b) due to the collection or increased collection of child/spousal support. Refugee Cash Assistance (RCA). Aid to the Aged In Home Support Services (IHSS). Covers emergency and pregnancy-related services to otherwise eligible children, without satisfactory immigration status who are ages 6 to 19 or beyond 19 when inpatient status begins before the 19th birthday and family income is at or below 100 percent of the federal poverty level. //]]> Share of cost is not the same as cost-sharing. BCCTP Undocumented Aliens. Kin-GAP Cash Assistance. Total Parenteral Nutrition (TPN). Breast cancer-related services covered for 18 months. 100 Percent Excess Property Child Pregnancy and Emergency Services Only. Allows special institutional deeming rules (spousal impoverishment) for MSSP transitional and non-transitional services for individuals 65 years of age or older.

Cancer Detection Programs:Every Woman Counts offers benefits to uninsured and underinsured women, 25 years and older, whose household income is at or below 200 percent of the Federal poverty level. =\=4\(T]^+a{)WIi8,R]%qr255%&iyeY>g J[ 0000010401 00000 n <>stream Kinship Guardianship Assistance Payment (Kin-GAP) Cash Assistance. AFDC-Foster Care.

133 Percent Program (OBRA). 0000005529 00000 n Provides for the pre-enrollment of children into the Medi-Cal program who are screened as probable for Healthy Families eligibility. Covers former Supplemental Security Income/State Supplementary Payment recipients who are blind, until the county redetermines their Medi-Cal eligibility. Aid to the Aged MSSP. x[msF)FIiN-V#d5L,i `xy _l7zjH]oU++sU$i*"Qqj,Ea&:1TJ0uY1{cl(GY <<3CBB2AB7D71CB846827B23F0C1E06BEF>]>> Emergency Assistance (EA) Foster Care. 133 Percent Excess Property Child Emergency Services Only. Accelerated Enrollment. CountyMedical Services Program (CMSP). Paper Medi-Cal ID Card issued. Upon certification of the SOC, an RR individual is not eligible for Medi-Cal benefits in this Medi-Cal Budget Unit (MBU). Cancer Detection Programs:Every Woman Counts only. xb```b`` @1VGdX3x$[2*PI-O/9kk?. SB 87 Pending Disability (SOC). Cost-sharing requires a recipient to pay a set amount or percentage of each health care service received, while share of cost requires recipients to take full responsibility for health care expenses up to a predetermined amount. Provides eligible pregnant aliens of any age without satisfactory immigration status with family planning, pregnancy-related and postpartum, if family income is at or below 200 percent of the federal poverty level. s:xS>X;OJd7JJxgtR! Um\-\y2$9!y//zOQdqHemy?HnMQ% &C>)#)7 i,r`F\v. Restricted to pregnancy-related and emergency services. Covers child welfare cases placed in EA foster care. For more information, refer to the Share of Cost (SOC) section of the Part 1 manual. Provides full-scope, no Share of Cost (SOC) Medi-Cal benefits for infants born to mothers who were enrolled in Medi-Cal with no SOC in the month of the infants birth. 7G is valid for Ambulatory Prenatal Care Services. 0000001558 00000 n Limited to two months. HAP Card Issued. CHDPTriZetto (formerly Gateway) Healthy Families. ("naturalWidth"in a&&"naturalHeight"in a))return{};for(var c=0;a=d[c];++c){var e=a.getAttribute("pagespeed_url_hash");e&&(! 0000003186 00000 n Valid for pregnancy verification office visit. Covers persons aged 21 years or older, with confirmed pregnancy, which meet the eligibility requirements of medically indigent. 2 0 obj Cost-sharing requires a recipient to pay a set amount or percentage of each health care service received, while share of cost requires recipients to take full responsibility for health care expenses up to a predetermined amount.

Post-BCCTP. endobj Provides full-scope benefits to otherwise eligible children, ages 6 to 19 or beyond 19 when inpatient status begins before the 19th birthday and family income is at or below 100 percent of the Federal poverty level.

MI Confirmed Pregnancy. Medi-Cal In-Home Operations (IHO) Waiver (No SOC). Covers eligible minors under age 12. Continuous Eligibility for Children (CEC). Provides limited-scope no SOC Medi-Cal emergency, pregnancy-related and Long Term Care (LTC) services for females younger than 65 years of age with unsatisfactory immigration status and without creditable health insurance coverage who have exhausted their 18-month (breast) or 24-month (cervical) period of cancer treatment coverage under aid code 0U. Minor Consent Program. trailer

Covers persons discontinued from CalWORKs or Section 1931(b) due to the increased collection of child/spousal support. Express Enrollment National School Lunch Program (NSLP). Covers those eligible for the Section 1931(b) program who do not have satisfactory immigration status. Provides a comprehensive health insurance plan for uninsured children from 1 to 19 years of age whose familys income is at or below 200 percent of the Federal poverty level. 0000007785 00000 n Covers former Supplemental Security Income/State Supplementary Payment recipients who are aged, until the county redetermines their Medi-Cal eligibility. 200 Percent FPL Infant (Income Disregard Program Infant). 0000005884 00000 n SB 87 Pending Disability.

Covers the disabled in the Aged and Disabled Federal Poverty Level program. Covers eligible aliens who do not have satisfactory immigration status. Provides temporary full-scope Medi-Cal benefits with no SOC. A child in this program is enrolled in a Healthy Families plan and is eligible for all CCS benefits Covers all eligible refugees during their first eight months in the United States, including unaccompanied children who are not subject to the eight-month limitation. BCCTP State-funded. They remain eligible while still in need of treatment and meet all other eligibility requirements. Does not cover individuals with expensive, creditable insurance. Covers eligible persons of any age who are eligible for parenteral hyperalimentation and related services and persons of any age who are eligible under the Medically Needy or Medically Indigent Programs. 0000008430 00000 n This option allows the Qualified Provider to make a determination of PE for outpatient prenatal care services based on preliminary income information. The chart includes only aid codes used to bill for services through the Medi-Cal claims processing systems and for other non-Medi-Cal programs that need to verify eligibility through EVS. Katrina-Covers eligible evacuees of Hurricane Katrina. Share of cost is also not a premium; it is an amount that a recipient is responsible for only during a month in which Medi-Cal's assistance with health care expenses is needed. Provides full-scope Medi-Cal benefits with a Share of Cost (SOC) for infants born to mothers who were enrolled in Medi-Cal with a SOC in the month of the infants birth and SOC was met. 18-months (breast) and 24-months (cervical).

Covers children on whose behalf financial assistance is provided for federal foster care placement. OBRA Alien Pregnant Woman. endobj TextPopupInit('HotSpot38775','POPUP38775'); xref % 0000002404 00000 n 501 0 obj<>stream California Work Opportunity and Responsibility to Kids (CalWORKs), Timed-Out, Safety Net All Other Families. Allows special institutional deeming rules (spousal impoverishment) for MSSP transitional and non-transitional services for individuals 65 years of age or older. Federal Poverty Level Aged (FPL-Aged). 100 Percent OBRA Child. 0000003862 00000 n Covers medically indigent persons under 21 who meet the eligibility requirements of medical indigence. Provides full-scope Medi-Cal benefits to eligible children ages 1 up to 6 or beyond 6 years when inpatient status, which began before 6th birthday, continues, and family income is at or below 133 percent of the federal poverty level. The individual may be eligible for Medi-Cal benefits in another MBU where the person is not identified as RR. 0?+Xs_7;9~%7 a~nd '?FBjx35! Aid to the Aged Multipurpose Senior Services Program (MSSP). Covers children for whom there is a state-only AAP agreement between any state other than California and adoptive parents. Covers children supported by public funds other than AFDC-FC. MI Adult Disability Pending. CHDPTriZetto (formerly Gateway) Deemed Infant SOC.

0000002857 00000 n Provides full-scope benefits to children up to 19 years of age who would otherwise lose their no Share of Cost Medi-Cal.

Persons may continue to be eligible under aid code 82 until age 22 if they have filed for a State hearing.

Upon certification of the SOC, the IE individual is not eligible for Medi-Cal benefits in this case. Entrant Cash Assistance (ECA). Provides emergency and pregnancy-related benefits (no Share of Cost) to children without satisfactory immigration status who are up to 19 years of age who would otherwise lose their no Share of Cost Medi-Cal. 0000020957 00000 n

Continuing TMC. Medi-Cal Dialysis Only Program/Medi-Cal Dialysis Supplement Program (DP/DSP). An IE person may be eligible for Medi-Cal benefits in another case where the person is not identified as IE. Please note:Cancer Detection Programs:Every Woman Counts and Medi-Cal are separate programs; however, Cancer Detection Programs:Every Woman Counts relies on the Medi-Cal billing process (with few exceptions). Covers eligible minors at least 12 years of age and under the age of 21. BCCTP. 4 0 obj Provides six months of coverage for eligible aliens without satisfactory immigration status who have been discontinued from Section 1931(b) due to increased earnings from employment. x&{1AE(u@,&EXjEvl*GkvIP%'%l}On4F O+z!01r.043Ga<5gV{b.x^HU!OdkK% 6B.z9pcN0Q/Vl7{q8O|Zt~gx!DbhQY{fY!ral$Z~Yow_!aU5teD='e;k(Oj}8NYQka2Xa4l://8%pkE0ll,xs){Cmw[A.q6\DuH5A =[ (.NsB87E FwyWQFWIt9kxxKVxxb6[ ~oa0bhW]"-hvfGi]Am/2/(4 b0NV:rsR6/. RR Responsible Relative:An RR is allowed to use medical expenses to meet the SOC for other family members for whom he/she is responsible. Presumptive Eligibility (PE) Ambulatory Prenatal Care. Covers eligible persons age 21 or older and under 65 years of age who are residing in a Nursing Facility Level A or B with or without SOC. Covers medically indigent adults aged 21 and over but under 65 years that meet the eligibility requirements of medically indigent and have a pending Medi-Cal disability application.

Eligible for GHPP benefits and case management. Under Color of Law (PRUCOL) aliens, and certain amnesty aliens. pregnancy-related and postpartum services if family income is at or below 200 percent of the federal poverty level. Covers persons until the age of 22 who were in an institution for mental disease before age 21. 0000000016 00000 n CalWORKs Legal Immigrant Two Parent Mixed. One-Month Medi-Cal to Healthy FamiliesBridge. CalWORKS Timed-Out, Safety Net Two-Parent Families. Provides 18 months of breast cancer treatments and 24 months of cervical cancer treatments for eligible all-age males and females 65 years of age or older, regardless of citizenship, who have been diagnosed with breast and/or cervical cancer.

Provides temporary full-scope Medi-Cal benefits with no SOC. Severely Impaired Working Individual (SIWI). Access for Infants and Mothers (AIM) Infants enrolled in Healthy Families (HF). Non-CalWORKS. MI Adult Disability Pending SOC. Restricted to parenteral hyperali-mentation-related expenses. 1 0 obj Valid only for ambulatory prenatal care services. Family PACT (FPACT). Covers Cuban/Haitian entrants during their first eight months in the United States who are receiving ECA benefits, including unaccompanied children who are not subject to the eight-month provision. 3 0 obj Adoption Assistance Program (AAP) Child. endobj 469 33 Provides full Medi-Cal benefits to eligible infants up to 1 year old or continues beyond 1 year when inpatient status, which began before first birthday, continues and family income is at or below 200 percent of the federal poverty level. %PDF-1.6 Adoption Assistance Program (AAP). 133 Percent Program. Provides payment of Medicare Part A premium and Part A and B coinsurance and deductibles for eligible low income aged, blind or disabled individuals. 0000002022 00000 n Adoption Assistance Program/Aid for Adoption of Children (AAP/AAC). Covers with no SOC beneficiaries ages 21 to 65 who have lost their non-disability linkage to Medi-Cal and are claiming disability. CCS authorization required. 2 0 obj AFDC-Foster Care. Provides eligibility for Continued Eligibility for Children (CEC) if for some reason the child is no longer eligible under AAP prior to his/her eighteenth birthday. Share of cost is also not a premium; it is an amount that a recipient is responsible for only during a month in which Medi-Cal's assistance with health care expenses is needed. Covers all eligible refugees during their first eight months in the United States, including unaccompanied children who are not subject to the eight-month limitation. Provides immediate, temporary, fee-for-service, full-scope Medi-Cal benefits to certain children under the age of 19. endobj (function(){var g=this,h=function(b,d){var a=b.split(". Covers persons 65 years of age or older who are medically needy and in LTC status. Does not cover individuals with creditable insurance. x][s~xRc ^R[2%N#6OWn\etNjG@7|h0^/zy^?ua}^n{z_\/(4!1IkV$d~D/_\}zJn^QL(qedG^6Vr@rr//_6Y"g[K5/^KJxtDQ#dD' IY]y$R%)slw'JG^Y]zw_vz1ayy%J53~$KOx/^L4O'q +W|F;JUMy6jId1g;AK{""`MJY3T=FhU,Gx-v5PZw1oM}F:#@#kk`P\ I},dRS la*(IL(;4v) 0000006171 00000 n Covers the aged in the Aged and Disabled FPL program that do not have satisfactory immigration status. is met. 0000006778 00000 n Provides full Medi-Cal benefits to eligible children ages 1 up to 6 or beyond 6 years when inpatient status, which began before 6th birthday, continues and family income is at or below 133 percent of the federal poverty level. Breast and Cervical Cancer Treatment Program (BCCTP) Accelerated Enrollment (AE). Restricted Federal Poverty Level Disabled. If a recipient has an unmet Share of Cost, an aid code is not returned, since the recipient is not considered eligible until the Share of Cost//

Minor Consent Program. Cancer Detection Programs:Every Woman Counts offers reimbursement for screening, diagnostic and case management services. )MEA?T;(Arwy,{'E{ )%~SO7Rrg|Q2|-{/_y#K4V^AIV$[_TosboWdB)- Hz (,c&qsY/.X,"5=)1bs v%Tu5/CKWhJBw/+4Gi|sH{J9RhsfmFq$dO> o. Restricted to dialysis and supplemental dialysis-related services.

0000004415 00000 n stream

Aid Code 8F appears as a special aid code and entitles the eligible client to acute inpatient services only while residing in a Nursing Facility Level A or B. Tuberculosis (TB) Program. Covers former Supplemental Security Income/State Supplementary Payment recipients who are disabled, until the county redetermines their Medi-Cal eligibility. Provides Medi-Cal at no SOC to women who, while pregnant, were eligible for, applied for, and received Medi-Cal benefits. Covers children receiving cash grants under the state-only AAP/AAC program. Interstate Compact on the Placement of Children (ICPC) Child. Provides an additional six months of emergency services coverage for those beneficiaries who received six months of initial TMC coverage under aid code 3T.