|
Program Code |
ACEDS Recert Period |
Processing Notes |
Full Definition |
010A
|
12 mos. |
|
Aged person non-eligible for Medicaid but meeting requirements of Qualified Individual (QI-1) program. Medicaid pays the full Medicare Part B Premiums.
|
010Q
|
12 mos. |
|
Aged person non-eligible for Medicaid but meeting eligibility requirements of Qualified Medicare Beneficiary (QMB) program and/or Special Low-Income Medicare Beneficiary (SLMB) program. Medicaid pays the full Medicare Part B Premiums. Note: Effective July 1, 2005, SLMB eligibility is only for the month of application and any eligibility during the 90-day retroactive period.
|
010S
|
12 mos. |
|
Aged person non-eligible for Medicaid but meeting eligibility requirements of Special Low-Income Medicare Beneficiary (SLIMB) program. Medicaid pays the full Medicare Part B Premiums.
|
| 050A |
12 mos. |
|
Disabled person non-eligible for Medicaid but meeting requirements of Qualified Individual (QI-1) program. Medicaid pays the full Medicare Part B Premiums.
|
050Q
|
12 mos. |
|
Disabled person non-eligible for Medicaid but meeting eligibility requirements of Qualified Medicare Beneficiary (QMB) program and/or Special Low-Income Medicare Beneficiary (SLMB) program. Medicaid pays the full Medicare Part B Premiums. Note: Effective July 1, 2005, SLMB eligibility is only for the month of application and any eligibility during the 90-day retroactive period.
|
| 050S |
12 mos. |
|
Disabled person non-eligible for Medicaid but meeting eligibility requirements of Special Low-Income Medicare Beneficiary (SLIMB) program. Medicaid pays the full Medicare Part B Premiums.
|
110
|
N/A
(categorically eligible) |
|
Aged person and receiving SSI and/or State Supplement. Eligible for Title XIX (Medicaid) reimbursement.
|
| 110Q |
N/A
(categorically eligible) |
|
Aged person and receiving SSI and/or State Supplement and is also eligible as a QMB and/or SLMB. Dually eligible for Title XVIII (Medicare) and XIX (Medicaid) reimbursement. Note: Effective July 1, 2005, SLMB eligibility is only for the month of application and any eligibility during the 90-day retroactive period.
|
| 113 |
N/A
(categorically eligible)
|
Processed by LTC unit only |
Aged person and receiving SSI personal needs allowance and subject to long term care financial provisions. Eligible for Title XIX (Medicaid) reimbursement.
|
113Q
|
N/A
(categorically eligible) |
Processed by LTC unit only |
Aged person receiving SSI personal needs allowance and subject to long term care financial provisions and is also eligible as a QMB and/or SLMB. Dually eligible for Title XVIII (Medicare) and XIX (Medicaid) reimbursement. Note: Effective July 1, 2005, SLMB eligibility is only for the month of application and any eligibility during the 90-day retroactive period.
|
120
|
N/A
(categorically eligible) |
|
Child under 19 receiving AFDC/TANF. Eligible for Title XIX (Medicaid) reimbursement.
|
130
|
N/A
(categorically eligible) |
|
Adult receiving AFDC/TANF. Eligible for Title XIX (Medicaid) reimbursement.
|
| 140 |
N/A
(categorically eligible) |
|
Blind person and receiving SSI and/or State Supplement. Eligible for Title XIX (Medicaid) reimbursement.
|
140Q
|
N/A
(categorically eligible) |
|
Blind person and receiving SSI and/or State Supplement and is also eligible as a QMB and/or SLMB. Dually eligible for Title XVIII (Medicare) and XIX (Medicaid) reimbursement. Note: Effective July 1, 2005, SLMB eligibility is only for the month of application and any eligibility during the 90-day retroactive period.
|
| 143 |
N/A
(categorically eligible)
|
Processed by LTC unit only |
Blind person receiving SSI personal needs allowance and subject to long term care financial provisions. Eligible for Title XIX (Medicaid) reimbursement.
|
143Q
|
N/A
(categorically eligible) |
Processed by LTC unit only |
Blind person receiving SSI personal needs allowance and subject to long term care financial provisions and is also eligible as a QMB and/or SLMB. Dually eligible for Title XVIII (Medicare) and XIX (Medicaid) reimbursement. Note: Effective July 1, 2005, SLMB eligibility is only for the month of application and any eligibility during the 90-day retroactive period.
|
150
|
N/A
(categorically eligible) |
|
Disabled person and receiving SSI and/or State Supplement. Eligible for Title XIX (Medicaid) reimbursement.
|
| 150G |
N/A
(categorically eligible) |
Processed by Medicaid Branch only |
Former SSI recipient who is deemed to be receiving SSI for purposes of Medicaid eligibility but not in receipt of any SSI cash payment. Eligible for Title XIX (Medicaid) reimbursement; may also be dually-eligible for Title XVIII (Medicare.)
|
| 150Q |
N/A
(categorically eligible)
|
|
Disabled person and receiving SSI and/or State Supplement and is also eligible as a QMB and/or SLMB. Dually eligible for Title XVIII (Medicare) and XIX (Medicaid) reimbursement. Note: Effective July 1, 2005, SLMB eligibility is only for the month of application and any eligibility during the 90-day retroactive period.
|
| 153 |
N/A
(categorically eligible) |
Processed by LTC unit only |
Disabled person receiving SSI personal needs allowance and subject to long term care financial provisions. Eligible for Title XIX (Medicaid) reimbursement.
|
| 153Q |
N/A
(categorically eligible) |
Processed by LTC unit only |
Disabled person receiving SSI personal needs allowance and subject to long term care financial provisions and is also eligible as a QMB and/or SLMB. Dually eligible for Title XVIII (Medicare) and XIX (Medicaid) reimbursement. Note: Effective July 1, 2005, SLMB eligibility is only for the month of application and any eligibility during the 90-day retroactive period.
|
| 160 |
N/A
(categorically eligible) |
Processed by Medicaid Branch only |
Child residing in the District of Columbia who is a ward of another state and who is not being involuntarily detained. Eligible for Title XIX (Medicaid) reimbursement.
|
| 161 |
N/A
(categorically eligible) |
Processed by Medicaid Branch only |
Child who is a ward of the District of Columbia Government (e.g., CFSA or DYRS customer) and who is not being detained in a penal institution. Eligible for Title XIX (Medicaid) reimbursement.
|
| 161M |
N/A
(categorically eligible) |
Processed by Medicaid Branch only |
Child who is a ward of the District of Columbia Government ( e.g., DYRS customer) and who is not being detained in a penal institution but rather is being served in a community setting. Eligible for Title XIX (Medicaid) reimbursement.
|
| 313 |
12 mos. |
Processed by LTC unit only |
Aged person meeting medically needy eligibility requirements and subject to long term care financial provisions. Eligible for Title XIX (Medicaid) reimbursement.
|
| 313Q |
12 mos. |
Processed by LTC unit only |
Aged person meeting medically needy eligibility requirements and subject to long term care financial provisions and is also eligible as a QMB and/or SLMB. Dually eligible for Title XVIII (Medicare) and XIX (Medicaid) reimbursement. Note: Effective July 1, 2005, SLMB eligibility is only for the month of application and any eligibility during the 90-day retroactive period.
|
| 320 |
12 mos. |
|
Child under 21 meeting AFDC/TANF definition and medically needy eligibility requirements, but not eligible for financial assistance. Eligible for Title XIX (Medicaid) reimbursement.
|
| 330 |
12 mos. |
|
Adult meeting AFDC/TANF definition and medically needy eligibility requirements, but not eligible for financial assistance. Eligible for Title XIX (Medicaid) reimbursement.
|
| 343 |
12 mos. |
Processed by LTC unit only |
Blind person meeting medically needy eligibility requirements and subject to long term care financial provisions. Eligible for Title XIX (Medicaid) reimbursement.
|
| 343Q |
12 mos. |
Processed by LTC unit only |
Blind person meeting medically needy eligibility requirements and subject to long term care financial provisions and is also eligible as a QMB and/or SLMB. Dually eligible for Title XVIII (Medicare) and XIX (Medicaid) reimbursement. Note: Effective July 1, 2005, SLMB eligibility is only for the month of application and any eligibility during the 90-day retroactive period.
|
353
|
12 mos. |
Processed by LTC unit only |
Disabled person meeting medically needy eligibility requirements and subject to long term care financial provisions. Eligible for Title XIX (Medicaid) reimbursement.
|
353Q
|
12 mos. |
Processed by LTC unit only |
Disabled person meeting medically needy eligibility requirements and subject to long term care financial provisions and also eligible as a QMB and/or SLMB. Dually eligible for Title XVIII (Medicare) and XIX (Medicaid) reimbursement. Note: Effective July 1, 2005, SLMB eligibility is only for the month of application and any eligibility during the 90-day retroactive period.
|
| 360 |
12 mos. |
|
Emancipated minor (under 21) meeting medically needy eligibility requirements. Eligible for Title XIX (Medicaid) reimbursement.
|
361
|
N/A
(categorically eligible) |
Processed by Medicaid Unit only |
Child under 21 who is a ward of the District of Columbia Government who is neither being maintained in a penal institution nor foster home setting. Rather, these customers are under the Shelter Care and Temporary Placement Program through CFSA. Eligible for Title XIX (Medicaid) reimbursement.
|
| 362 |
N/A
(categorically eligible) |
Processed by Medicaid Unit only
|
Child under 21 is a ward of the District of Columbia Government who is in the Guardianship program (e.g., CFSA client). Eligible for Title XIX (Medicaid) reimbursement.
|
| 370 |
12 mos. |
|
Special Needs: 50-64. Eligible for Medicaid.
|
| 420 |
12 mos. |
Processed by Multi-National Unit only |
Non-qualified alien child under 21 eligible for Immigrant Children’s Program. |
