Ch. 8-Non-MAGI Intro

Question 1

What is the most important thing to know about being evaluated for non-magi?

Answer 1

You must have linkage linkage equals eligibility to non-Magi.

Question 2

What are the linkages for non-magi?

Answer 2

Medically needy, such as age, blind, or disabled, who meets one of the following conditions, not eligible for or does not want to receive assistance as a public assistance or other public assistance recipient have an application pending for SSI/SSP
Or a child or family member, who is both linked to AFDC, not eligible for, does not want to receive assistance as a public assistance or other public assistance, recipient, or
a caretaker relative who chooses to be included in a child’s MFBU in accordance with a caretaker relative, who establishes AFDC linkage to a public assistance

Question 3

In non-magi world how old is a child?

Answer 3

Under 21 years of age

Question 4

Who are linked to non-magi?

Answer 4

-Aged blind disabled
-AFDC medically needy-linkage to the AFDC-MN program is established by parent/caretaker, living with a child or children, for whose care of the parent caregiver relative has primary responsibility. Children no longer need deprivation to be eligible for this group, if they are living with a parent, caretaker or relative
-Pregnant women are linked to non-magi for the AFDCMN program the unborn child provides linkage from conception
-children under 21 living with a parent or linked
-Parent caretakers. This includes step parents, regardless of tax filing as long as parent caretaker is exerting care, and control the child and the child lives with the parent caretaker.
Category two medically indigent

Question 5

For our non-magi category to our medically indigent, who are these people?

Answer 5

Children under 21 pregnant women resident of an LTC, which means in a facility for 30 days or more with no other linkage in the facility for 30 days or more. Just remember linkage is required for all non-magi medical programs.

Question 6

For non-magi programs remember, what is one of the most important things that they all have for non-magi?

Answer 6

Non-magi programs have a resource test, no income limit

Question 7

What is the criteria for pregnant women who are linked to non-magi?

Answer 7

One for the FDCNMN program the unborn child provides linkage from conception.
Once a pregnant woman has been approved for medical services increases in. The income are not counted in her SOC share of cost determination for pregnancy related services until the end of her 12 months postpartum.
A pregnant woman who is eligible for and received medical during the last month of pregnancy, is eligible to Medi-Cal for a 12 month postpartum. Period.
An infant whose mother is Eligible before, and receiving Medi-Cal in the month of delivery, is automatically deemed eligible for a fullscope Medi-Cal for one year

Question 8

How long is an infant eligible for medical?

Answer 8

The infant is automatically deemed eligible for one year for fullscope medical

Question 9

What category one for non-magi linkage?

Answer 9

1) aged blind disabled
2) request to be evaluated to see if they qualify can get care for 90 days while being determined for eligibility
3) AFDC-MN (aid for dependent children-medically needy) parents caregivers are linked to non-magi
4) pregnant women are linked to non-magi the unborn child provides linkage from conception
5) children under 21 who live with a parent have linkage
Parent caretakers this includes stepparents, regardless of tax filing. As long as a parent caretaker is exerting care, and control the child and the child lives with a parent caretaker.
6) medically indigent considered category two
7) children under 21
8) pregnant women
9) a resident of an LTC (long-term care)

Question 10

What does DDSD stand for?

Answer 10

Disability, determination, services, division

Question 11

What does AFDC stand for?

Answer 11

Aid to family with dependent children

Question 12

What does SOC stand for?

Answer 12

Share of cost

Question 13

What is non-magi medical?

Answer 13

They are the umbrella term for Medi-Cal programs that are not magi

Question 14

What is good customer service regarding healthcare services?

Answer 14

It is good customer service to notify an applicant who is not receiving zero share of cost magi Medi-Cal about their option to apply for non-magi. However, the state has stated that we are not required to do an evaluation unless the client is ABD, which stands for aged, blind disabled, or request an evaluation

Question 15

How is a person’ eligibility determined under the medically needy program?

Answer 15

If that person is of the following age, blind, or disabled, who meets one of the following conditions;
1) is not eligible for or does not want to receive assistance as a public assistance or other public assistance recipient
2) has an application, pending for SSI/SSP

Question 16

How is a person’s eligibility determined under the medically needy program under the following as well?

Answer 16

They are linked if a child or family member is both linked to AFDC in accordance with the mpg article 5, section 2, and not eligible for or does not receive assistance as a public assistance or other public assistance, recipient, or
A caretaker relative who chooses to be included in a child’s MFBU in accordance with mpg article 8, section 5 and a caretaker relative who establishes AFDC linkage to public assistance or other public assistance child in accordance with mpg article 8 section 5

Question 17

With ABD linkage, who are the only people linked to medical?

Answer 17

Aged blind, and disabled

Question 18

What is considered aged?

Answer 18

65 and older

Question 19

Who is considered blind?

Answer 19

Those deemed blind by the SSA-social Security administration

Question 20

What does SSA stand for?

Answer 20

Social Security administration

Question 21

Who is deemed disabled?

Answer 21

A person is deemed disabled by the SSA, Social Security Administration, or the DDSD-disability, determination services division

Question 22

What happens if a person is not deemed disabled?

Answer 22

If someone who is over income for magi yet claims to be disabled, there is a process called DDSD, disability, determination, services, division. The DDSD makes an evaluation on their disability based on the information supplied by the customer the customer well also I’ve had to applied for SSA, and the following information must be submitted to the state.
1. SSA
2) any documentation or medical evidence
3) guidelines to come requesting medical
4) copy of the death certificate, if available (do not hold the packet, if unavailab)

Question 23

When a person requests to be evaluated for disabled by the DDSD they are given a packet to complete. What happens with the packet?

Answer 23

The packet must be completed. If the packet is incomplete or missing information it will be returned by the DDSD

Question 24

How many days does a DHCS-services have to come back with their decision for disability?

Answer 24

They have 90 days

Question 25

Are there categories where a person can be presumed disabled while waiting for the DHCS decision?

Answer 25

A presumptive disability verification requirement is a presumptive disability can be verified by completion of form CSF 2080 in CalWIN or a letter from a physician, licensed or certified psychologist or authorized member of their staff use form DHS7035A/DHS7035C for HIV or form CMS 2728 for end-stage renal disease.
Presumptive disability will be granted when an applicant meet any of the following conditions is the applicants condition does not exactly match the categories based below referred to the case to DDSD for an urgent presumptive disability determination .
1) obsolete, reserved for future use
2) amputation of a leg at the hip
3.) allegation of total deafness.
4) allegation of total blindness
5) allegation of bed confinement are in mobility without a wheelchair walker or crutches, due to long-standing condition, excluding recent accident or recent surgery