Family & Children's Medicaid Change Notices

A. MA-3110, Definitions, has had the following definitions added or changed:

B. MA-3205, conducting a Face-to-Face Interview has been changed to add references to HCWD.

C. MA-3230, Eligibility of Individuals Under Age 21, has been changed to add background material and basic eligibility requirements for the HCWD program.

D. MA-3410, Terminations and Deletions, has been changed to add references to HCWD.

E. See MA-2180, Health Coverage for Workers with Disabilities, which has been added to the Aged, Blind and Disabled Medicaid Manual, for HCWD policy.

F. See ABD Change Notice No. 24-08 for HCWD EIS policy.

A. Remove: MA-3110, Definitions, pages 3-12 and 27-28.

Insert: MA-3110, Definitions, pages 3-12 and 27-28.

B. Remove: MA-3205, Conducting a Face-to-Face Intake Interview, pages 1- 6.

Insert: MA-3205, Conducting a Face-to-Face Intake Interview, pages 1- 6.

C. Remove: MA-3230, Eligibility of Individuals Under Age 21, pages 1-30.

Insert: MA-3230, Eligibility of Individuals Under Age 21, pages 1-31.

D. Remove: MA-3410, Terminations/Deletions, pages 5-6.

Insert: MA-3410, Terminations/Deletions, pages 5-6.

CHANGE NOTICE FOR MANUAL NO. 17-08, HEALTH COVERAGE FOR WORKERS WITH DISABILITIES

DATE: 11/01/08

Manual: Aged, Blind, and Disabled Medicaid

Change No: 17-08

To: County Directors of Social Services

Effective: 11/01/08

Make the following change(s)

I. BACKGROUND

The federal Ticket to Work and Work Incentives Improvement Act (TWWIIA) of 1999 offers states the option to protect Medicaid coverage for workers with disabilities. People with disabilities are often discouraged from working for fear that their earnings would make them ineligible for Medicaid. TWWIIA offers state Medicaid programs options to expand Medicaid eligibility criteria for workers with disabilities. Additionally, it provides support for the states in developing programs to reduce barriers to and create work incentives for persons with disabilities. This support comes in the form of Medicaid Infrastructure Grants.

North Carolina is authorized to provide Medicaid for disabled workers under the Health Coverage for Workers with Disabilities Act (G.S. 108A-54.1). Health Coverage for Workers with Disabilities (HCWD) provides an incentive for persons with disabilities to go to work or to increase their hours of work while protecting their Medicaid eligibility.

II. INTRODUCTION

HCWD covers blind or disabled workers age 16 through 64 with incomes equal to or less than 150% of the federal poverty level. The resource limit is the minimum community spouse resource standard, currently $20,880. HCWD recipients are entitled to full Medicaid coverage under MAB or MAD. Recipients age 16 through 20 are also entitled to additional services provided under EPSDT. HCWD consists of two groups, the Basic Coverage Group and the Medically Improved Coverage Group. HCWD recipients can not be receiving under any CAP program at this time. CAP recipients will be eligible for HCWD at a later time.

III. CONTENT OF CHANGE

A. MA-3110, Definitions, has had the following definitions added or changed:

1. Authorized Representative.

2. Client.

3. Health Coverage for Workers with Disabilities.

4. Money Follows the Person.

5. Representative.

B. MA-3205, conducting a Face-to-Face Interview has been changed to add references to HCWD.

C. MA-3230, Eligibility of Individuals Under Age 21, has been changed to add background material and basic eligibility requirements for the HCWD program.

MA-3230 II. Defines the eligibility requirements. To qualify for HCWD an individual must:

1. Be age 16 through 64;

2. Meet the Social Security Administration definition of disability, except for earnings, or meet the Division of Services for the Blind (DSB) blindness criteria, or be eligible in the Medically Improved Group;

3. Be employed;

4. Have countable resources equal to or less than the minimum community spouse resource allowance;

5. Meet the income requirements for his coverage group;

6. Meet all the other eligibility requirements applicable to Adult Medicaid coverage groups.

D. MA-3410, Terminations and Deletions, has been changed to add references to HCWD.

E. See MA-2180, Health Coverage for Workers with Disabilities, which has been added to the Aged, Blind and Disabled Medicaid Manual, for HCWD policy.

F. See ABD Change Notice No. 24-08 for HCWD EIS policy.

.

Iv. Effective Date and implementation

This policy is effective November 1, 2008. Apply this policy to any applications or redeterminations in process or taken on or after November 1, 2008.

V. Maintenance of Manual

A. Remove: MA-3110, Definitions, pages 3-12 and 27-28.

Insert: MA-3110, Definitions, pages 3-12 and 27-28.

B. Remove: MA-3205, Conducting a Face-to-Face Intake Interview, pages 1- 6.

Insert: MA-3205, Conducting a Face-to-Face Intake Interview, pages 1- 6.

C. Remove: MA-3230, Eligibility of Individuals Under Age 21, pages 1-30.

Insert: MA-3230, Eligibility of Individuals Under Age 21, pages 1-31.

D. Remove: MA-3410, Terminations/Deletions, pages 5-6.

Insert: MA-3410, Terminations/Deletions, pages 5-6.

For information regarding Medicaid, please contact your Medicaid Program Representative. For any Medicaid issues that are not able to be handled through that venue, Angela Floyd, Assistant Director for Recipient and Provider Services, will be your point of contact and can be reached at (919) 855-4000.

Tara R. Larson, Acting Director

(This material was researched and written by William Appel and John Benske, Policy Consultants, Medicaid Eligibility Unit.)