Adult Medicaid Manual MA-200 DEFINITIONS

II. PROGRAMS

Benefit Diversion --- A cash payment assistance alternative to traditional Work First Family Assistance (WFFA) for families with a temporary, non-recurring situation associated with employment or other sources of financial stability.

Breast and Cervical Cancer Medicaid --- A program of medical assistance for women enrolled and screened for breast and cervical cancer through the Breast and Cervical Cancer Control Program.

Emergency Assistance --- A cash payment program to assist families with children who are in a crisis situation.

Community Alternative Programs (CAP) --- Special Medicaid for individuals placed in the community who are at risk of institutionalization.

MFP --- Money Follows the Person. MFP provides the services and supports necessary to allow Medicaid eligible people, who meet the criteria for enrollment in CAP/Choice, CAP/DA, CAP-MR/DD, or PACE to move out of institutions and back home or into the community.

Energy Assistance --- Cash payments offered to eligible households to help defray the high cost of heating/cooling.

a. CIP --- Assistance with heating or cooling related emergencies.

b. LIEAP (LIHEAP) --- Annual cash payment to low-income households to assist with heating costs.

c. Other Energy Assistance Resources --- Private and/or public moneys available in some counties to assist low-income households with heating or cooling costs (i.e. Project Share, FEMA, etc.).

Expanded Foster Care Program (EFCP)--- for IAS and HSF adolescents ages 18, 19, and 20 will be without regard to the adolescent’s assets or income levels through the month they turn age 21.

Food and Nutrition Services --- A program to assist eligible households with the purchase of food.

Health Coverage for Workers with Disabilities (HCWD) --- A program to allow individuals with disabilities to work and receive income while maintaining Medicaid benefits.

Low Income Subsidy --- A program that provides additional assistance for Medicare beneficiaries with income less than 150% of the federal poverty level for the Medicare Part D program.

Medicaid Family Planning Waiver (FPW)--- A program for men, ages 19 through 60, and women, ages 19 through 55, with income at or below the 185% of the poverty level, to receive family planning services.

Medical Assistance --- (Medicaid) A program to assist eligible aged, disabled, blind, individuals, pregnant women, families and/or children with the cost of medical care.

M-AA --- Medicaid to the Aged. A program of medical assistance for individuals age 65 and over.

REISSUED 11/01/08 – CHANGE NO. 24-08

(II.)

M-AB --- Medicaid to the Blind. A program of medical assistance for individuals of any age who meet Social Security's definition of blindness.

M-AD --- Medicaid to the Disabled. A program of medical assistance for individuals under age 65 who meet Social Security's definition of disability.

M-AF --- Medicaid to Families with Dependent Children. A program of medical assistance for children and adults who meet the requirements of eligibility.

a. MAF-D --- Medicaid Family Planning Waiver

b. MAF-W --- Breast and Cervical Cancer Medicaid

M-IC --- Medicaid to Infants and Children. A program for medical assistance for children under the age of 19 whose countable income falls under a specified percentage of the Federal Poverty Limit.

M-PW --- Medicaid for Pregnant Women. A program for medical assistance for pregnant women whose income falls under a specified percentage of the Federal Poverty Limit.

M-QB-B --- Specified Low Income Medicare Beneficiaries. A limited Medicaid program which pays a recipient's Medicare B premiums only.

M-QB-Q --- Qualified Medicare Beneficiaries. A limited Medicaid program that pays a recipient's Medicare premiums, deductibles and copayments only.

M-QB-E --- Qualifying Individual 1 (QI1). A limited Medicaid program which pays a recipient’s Medicare B premiums only. Funding for the program is capped.

M-RF --- Refugee Assistance. A medical assistance program for refugees.

M-SB --- Medicaid for Special Assistance to the Blind. A medical assistance program for recipients of Special Assistance to the Blind money payments.

M-WD --- Qualified Disabled Working Individuals. Individual who is eligible for Medicaid payment of Medicare Part A premiums after automatic entitlement to free Part A ends due to individual's earnings and whose income does not exceed 200% of poverty level. This is the only Medicaid benefit covered by this program.

NCHC --- North Carolina Health Choice for Children. A health insurance program for uninsured children under the age of 19 who do not qualify for Medicaid and have family income under 200% of the Federal Poverty Limit. Funding for this program is capped. This program is known as Children’s Health Insurance Program (CHIP) at the national level.

REVISED 03/01/11 – CHANGE NO. 03-11

(II.)

PACE --- Program of All-inclusive Care for the Elderly. A managed care service delivery for the frail community-dwelling elderly, most of whom are dually eligible for Medicare and Medicaid benefits, and all of whom are certified eligible for nursing home placement according to North Carolina standards.

Pregnancy Medical Home (PMH) -- A managed care service that assists pregnant Medicaid recipients with perinatal care (the period immediately before and after birth) thereby ensuring healthy pregnancies and improving birth outcomes. This will be done by modeling the PMH after the enhanced primary care case management (PCCM) program developed by CCNC.

Special Assistance - (SA)

a. Adult Care Home --- Cash payments and medical assistance for eligible aged, disabled and blind individuals residing in a licensed adult care home facility.

b. Certain Disabled --- Cash payment only for individuals in a private living arrangement who meet the state's definition of disability. (This program is not available in all counties.)

c. In-home --- Cash payments and medical assistance for eligible aged, disabled and blind individuals residing in a private living arrangement who are at risk of placement in an adult care home.

Work First Family Assistance --- A cash payment and Medicaid program for families with children who are low income. This program is known as TANF at the national level.