Family Medicaid Transitional Medical Assistance TMA is an

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Family Medicaid Transitional Medical Assistance

Family Medicaid Transitional Medical Assistance

TMA is an extended type of medical assistance designed specifically to help working families.

TMA is an extended type of medical assistance designed specifically to help working families. ETS – Results That Matter!

ETS – Results That Matter!

ETS – Results That Matter!

A LIM AU may become eligible for TMA if LIM ineligibility is due to

A LIM AU may become eligible for TMA if LIM ineligibility is due to new or increased earned income; loss of $30 deduction; or loss of 1/3 deduction. ETS – Results That Matter!

New or Increased Earned Income n n n New or increased earnings of an

New or Increased Earned Income n n n New or increased earnings of an adult New employment Increase in hours worked Increase in salary or hourly wage Earnings of eligible adult added to LIM ETS – Results That Matter!

Potential Time Period Initial six months Additional six months ETS – Results That Matter!

Potential Time Period Initial six months Additional six months ETS – Results That Matter!

Initial Six Months n Financially ineligible for LIM n Correctly received LIM 3 of

Initial Six Months n Financially ineligible for LIM n Correctly received LIM 3 of last 6 months n Include a child under 18 ETS – Results That Matter!

Additional Six Months n Received TMA for initial six months n Met 4 th

Additional Six Months n Received TMA for initial six months n Met 4 th month reporting requirements n Include a child under 18 ETS – Results That Matter!

Timely Report AU has 10 days to report change Case Manager has 10 days

Timely Report AU has 10 days to report change Case Manager has 10 days to request verification and process If ineligible, AU will receive 14 days Timely Notice ETS – Results That Matter!

ETS – Results That Matter!

ETS – Results That Matter!

Untimely Report n n Complete trial budget Determine effective month if reported timely TMA

Untimely Report n n Complete trial budget Determine effective month if reported timely TMA begins month after TN would have expired Establish LIM received in 3 of last 6 months ETS – Results That Matter!

ETS – Results That Matter!

ETS – Results That Matter!

ETS – Results That Matter!

ETS – Results That Matter!

Loss of $30 or 1/3 Deduction Complete trial budget n Establish LIM received 3

Loss of $30 or 1/3 Deduction Complete trial budget n Establish LIM received 3 of last 6 months n TMA begins month following LIM eligibility n ETS – Results That Matter!

ETS – Results That Matter!

ETS – Results That Matter!

CHANGE Month 11 06 AU ID xxxx 00197 Confirm Y NON-FINANCIAL ELIGIBILITY RESULTS -

CHANGE Month 11 06 AU ID xxxx 00197 Confirm Y NON-FINANCIAL ELIGIBILITY RESULTS - ELIG Prog MA Prog Type F STAT 01 A Med COA F 01 AU AU Status AU Stat Appl Begin Pd Thru ---Penalty--Stat Reasons Date Type End Date A 030506 030206 030106 ---------------------------------------First Last Rel V Mand Finl --Stat-- Rsn Appl Begin Pd Thru Penalty Name Incl Resp Date T Date ANTONI KLE SE OT Y RE A 030506 030206 TISHA KLE SP OT Y RE A 030506 030206 KARMEN KLE CH OT Y RE A 030506 030206 CHARLE KLE CH OT Y RE A 030506 030206 Message ETS – Results That Matter!

CHANGE Month 11 06 EARNED INCOME 2 - ERN 2 Client Name ANTONIO KLEIN

CHANGE Month 11 06 EARNED INCOME 2 - ERN 2 Client Name ANTONIO KLEIN ERN 2 01 01 Client ID XXXX 00292 Employer Name HOME DEPOT Avg Hrs 40 Freq WK Day Week Pd TH Extra Pay Del Amt 1 V Amt 2 V Amt 3 V Amt 4 V Extra V 400. 00 LE -------------Work Expenses -----------------Type Amount Freq V More Jobs Message 0013 REQUIRED FIELDS ARE IDENTIFIED BY "? " 15 -lett 16 -evnc ETS – Results That Matter! 23 -alau 24 -del

CHANGE Month 11 06 AU ID XXXX 00197 Confirm Y NON-FINANCIAL ELIGIBILITY RESULTS -

CHANGE Month 11 06 AU ID XXXX 00197 Confirm Y NON-FINANCIAL ELIGIBILITY RESULTS - ELIG Prog MA Prog Type F ELIG 01 A Med COA F 07 AU AU Status AU Stat Appl Begin Pd Thru ---Penalty--Stat Reasons Date Type End Date A 030506 030206 030106 ---------------------------------------First Last Rel V Mand Finl --Stat-- Rsn Appl Begin Pd Thru Penalty Name Incl Resp Date T Date ANTONI KLE SE OT Y RE A 030506 030206 TISHA KLE SP OT Y RE A 030506 030206 KARMEN KLE CH OT Y RE A 030506 030206 CHARLE KLE CH OT Y RE A 030506 030206 Message ETS – Results That Matter!

CHANGE Month 11 06 AU ID XXXX 00197 CASH/MA FINANCIAL ELIGIBILITY - CAFI Prog

CHANGE Month 11 06 AU ID XXXX 00197 CASH/MA FINANCIAL ELIGIBILITY - CAFI Prog Type F Med COA F 07 Net Income Test (cont) Resources Standard - 30 1/3 Resource Limit. 00 Dependent Care Total Resources. 00 Net Earned Income Gross Income Test Net Unearned Income Gross Income Limit. 00 Deemed Income Gross Earned Income. 00 Allocated Income Net Unearned Income. 00 Net Income Deemed Income. 00 Grant Amount Allocated Income. 00 Recoupment Amount Total Gross Income. 00 Benefit Amount Net Income Test Previous Benefit Net Income Limit. 00 Spenddown Amount Gross Earned Income. 00 Medical Expense Amt Self Employ Work Exp. 00 Net Spenddown Amt Bnft Eff Date 100506 Bnft Confirm Y Reasons P Notice Type 0003 Waive Timely Ntc Period Review Begin Date 09 06 Review End Date 04 07 Message CAFI A Prog MA 13 -note ETS – Results That Matter! . 00. 00. 00 Budgeting Method Notice Override Strat 2

CHANGE Month 11 06 HOH Name ANTONIO AU ID XXXX 00197 Pre Issn AU

CHANGE Month 11 06 HOH Name ANTONIO AU ID XXXX 00197 Pre Issn AU NON-FINANCIAL MISCELLANEOUS - MISC 5991 10 05 06 KLEIN Prog MA MISC A Client ID XXXX 00292 Pre AU ATP QRF Pre- Calc Trial Pro Exp SLAM -Extended MAEBT Issn Prnt Cyc Status Ctr sump Elig HH Ovr Svc Cd Start Dt COA Card Mode Cnty Num Code Elig Ind Cor 11 06 Y ----- Review ---Compl Mand Last Std Type Auto Lump Sum Delay QMB Reasgn Remain Rsn Ovr Amount Y Sched Interview QC Penalty End Date Del Unit Number 179502 Inquiry Date 10 05 06 Load ID Next Review A Appt Date Appt Type Appt Begin Time (HH: MM) : Appt End Time (HH: MM) : Appt Letter Print Location L L Name/Appt Remarks Message 13 -note 14 -schd 15 -lett 20 -schs ETS – Results That Matter! 23 -alau RSM Elig Ovr

UPDATE REMARKS - REMA 01 ***************** TMA/F 07 ***************** 10/05/2006 12: 35 PM SUCCESS

UPDATE REMARKS - REMA 01 ***************** TMA/F 07 ***************** 10/05/2006 12: 35 PM SUCCESS Training 555 -5555 For F 07, months of eligibility : _ 11/06____ to : _10/07_______ Document reason for LIM ineligibility: __INCREASED WAGES – AR NOW EARNS $10/HR @ 40 HRS/WK__________________________ More MESSAGE 13 -bott ETS – Results That Matter!

CHANGE Month 11 06 AU ID XXXX 00197 CASH/MA FINANCIAL ELIGIBILITY - CAFI Prog

CHANGE Month 11 06 AU ID XXXX 00197 CASH/MA FINANCIAL ELIGIBILITY - CAFI Prog Type F Med COA F 07 Net Income Test (cont) Resources Standard - 30 1/3 Resource Limit. 00 Dependent Care Total Resources. 00 Net Earned Income Gross Income Test Net Unearned Income Gross Income Limit. 00 Deemed Income Gross Earned Income. 00 Allocated Income Net Unearned Income. 00 Net Income Deemed Income. 00 Grant Amount Allocated Income. 00 Recoupment Amount Total Gross Income. 00 Benefit Amount Net Income Test Previous Benefit Net Income Limit. 00 Spenddown Amount Gross Earned Income. 00 Medical Expense Amt Self Employ Work Exp. 00 Net Spenddown Amt Bnft Eff Date 100506 Bnft Confirm Y Reasons P Notice Type 0003 Waive Timely Ntc Period Review Begin Date 09 06 Review End Date 10 07 Message CAFI A Prog MA . 00. 00. 00 Budgeting Method Notice Override Strat 2 13 -note SUCCESS adjusts the Review End Date to reflect the end of the 12 month coverage period ETS – Results That Matter!

Initial Six Month Period No resource requirement n No income requirement n Wages must

Initial Six Month Period No resource requirement n No income requirement n Wages must be verified n Budget income on TMAI n ETS – Results That Matter!

Additional Six Month Period Comply with 7 th and 10 th month reporting n

Additional Six Month Period Comply with 7 th and 10 th month reporting n Meet income requirements n Include employed caretaker/adult n ETS – Results That Matter!

Good Cause Involuntary loss of employment n Illness of A/R or immediate family member

Good Cause Involuntary loss of employment n Illness of A/R or immediate family member n Family emergency n Child care not available n Transportation not available n ETS – Results That Matter!

QRF Processing n SUCCESS sends l 3 rd month l 6 th month l

QRF Processing n SUCCESS sends l 3 rd month l 6 th month l 9 th month n A/R returns l 4 th month l 7 th month l 10 th month ETS – Results That Matter!

QRF CHNGE Month 02 07 HOH Name ANTONIO AU ID XXXX 00197 TMA INCOME

QRF CHNGE Month 02 07 HOH Name ANTONIO AU ID XXXX 00197 TMA INCOME - TMAI KLEIN Client ID XXXX 00292 Date QRF Received 02 04 07 QRF Status Code C QRF Good Cause QRF Months Gross Inc V 01 07 12 06 11 06 2000. 00 1600. 00 TMAI Unemployed Good Cause Dep Care QR QR QR 0 0 0 RSN QRF Incomplete V CS CS CS Message 0013 01 0013 REQUIRED FIELDS ARE IDENTIFIED BY "? " ETS – Results That Matter! A

QRF CHNGE Month 02 07 TMA INCOME - TMAI HOH Name KELLY AU ID

QRF CHNGE Month 02 07 TMA INCOME - TMAI HOH Name KELLY AU ID XXXXX Date QRF Received 02 04 07 QRF Months 01 07 12 06 11 06 LANDON TMAI Client ID XXXXX QRF Status Code QRF Good Cause Gross Inc V Unemployed Good Cause RSN QRF Incomplete C 2750. 00 2200. 00 Dep Care qr qr qr 150. 00 120. 00 V cs cs cs Message 0013 01 0013 REQUIRED FIELDS ARE IDENTIFIED BY "? " ETS – Results That Matter! A

Group Exercise ETS – Results That Matter!

Group Exercise ETS – Results That Matter!

ETS – Results That Matter!

ETS – Results That Matter!

ETS – Results That Matter!

ETS – Results That Matter!

ETS – Results That Matter!

ETS – Results That Matter!

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