Family and Children's Medicaid MA-3400 FOUR MONTHS TRANSITIONAL MEDICAID

II. Policy Rules

A. Initial Eligibility

To be eligible for four months transitional Medicaid, the Work First or MAF-C assistance unit must:

1. Be financially ineligible for Work First or MAF-C because of new or increased child/spousal support, which is collected by Child Support Enforcement (IV-D) or received by a member of the assistance unit and forwarded to IV-D. Ineligibility may be caused by support alone or in combination with other increased income.

Note: If new or increased child/spousal support combined with an increase in earned income of the parent/specified relative causes ineligibility, transfer the case to Twelve Months Transitional Medicaid for Working Families. See MA-3405, Twelve Months Transitional Medicaid.

2. Have been eligible and received Work First (including benefit diversion) or MAF-C in at least three of the six months immediately preceding the first month of ineligibility for Work First or MAF-C. For purposes of this determination a $0 pay month due to Work First payment of less than $25 is a month of Work First receipt.

3. Continue to have an eligible child in the home.

4. Continue to live in North Carolina.

B. Length of Transitional Period

1. The transitional period is four consecutive months. The four month period begins the first month the case is ineligible due to child support after timely or adequate notice requirement is met.

(II.B.)

2. Timely Reporting: Determine the first month of the transitional period, depending on the date the increase is reported and the notice requirements. Transfer the case to AAF Payment Type 4 effective the first month of eligibility for 4 Months Transitional Medicaid.

Timely Example: In early April the parent/specified relative reports child support that is sufficient to make the case financially ineligible for Work First or MAF-C. May or June is the first month of the 4 month transitional period, depending on the date the increase is reported and the notice requirements sent.

3. Non-Timely Reporting: Determine the first month of the transitional period as if the child/spousal support were reported timely and the appropriate notice had been given. Transfer the case to AAF Payment Type 4 effective the first month of eligibility for 4 Months Transitional Medicaid. The transfer can be retroactive.

Example: On June 24, the parent/specified relative reports child support beginning in early April that is sufficient to make the case financially ineligible for Work First or MAF-C. May or June is the first month of the 4 month transitional period, depending on the date the change occurred and the notice requirements. Transfer the case to AAF Payment Type 4 effective May or June.

4. Key a DSS-8125 to transfer the Work First or MAF-C case to AAF Payment Type 4. Refer to EIS Manual.

5. When the case is transferred, EIS generates a DSS-8110 unless it is overridden, to notify the assistance unit. The notice indicates the months the assistance unit continues to receive transitional Medicaid. Refer to EIS 4000, Appendix E.

C. Do not count the child support as unearned income during the 4 months Transitional Medicaid period.







For questions or clarification on any of the policy contained in these manuals, please contact your local county office.