Overview Expanding Foundations: Non-MAGI. Group Expectations Stay PresentRespect each individual’s right to learnCritique ideas, not individualsOwn your.

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Presentation transcript:

Overview Expanding Foundations: Non-MAGI

Group Expectations Stay PresentRespect each individual’s right to learnCritique ideas, not individualsOwn your own learningChallenge yourselfTake care of yourself Page 4

Housekeeping Location of bathrooms Breaks and lunches Safety Computer use Food and drink Clean-up Training materials

Objectives: After this module, Participants will be able to:  Identify eligibility differences between MAGI and Non-MAGI.  Associate SSI, SSDI and SSA with Medicaid or Medicare appropriately.  Recognize what approval for lower level MA hierarchy categories means for other MA category decisions. Non-MAGI Overview Page 5 Goal: To gain further understanding of Medical Assistance programs, Social Security programs and how they relate.

MAGI vs. Non-MAGI What do we remember from EF: MAGI?

MAGI vs. Non-MAGI Non-MAGI  Household is now Married/in the Home  Introduction or Resource limits  Aged, Blind, and Disabled populations  Programs were not part of ACA Page 6

Social Security Administration (SSA)  Social Security Retirement  Social Security Disability Insurance  SSDI  Medicare  Supplemental Security Income  SSI

SSDI and SSA retirement Title II  Work Quarters  No Income and Resource Checks  Funded by payroll tax  Medicare  Disabled or Retired (62+)

SSI Title XVI  Not enough work quarters  Or not insured  Income and Resource Checks  Discretionary Federal funding  Medicaid  Disabled or 65+  Maximum benefit $733 in 2016

Non-MAGI Programs SSI related programs  SSI  Disabled Adult Child (DAC)  Qualified Disabled Widow(er) (QDW)  Pickle Page 8

Non-MAGI Programs Medicare related programs  Qualified Medicare Beneficiary (QMB)  Special Low-income Medicare Beneficiary (SLMB)  Qualified Individual-1 (QI-1)  Qualified Disabled Working Individual (QDWI)  Low Income Subsidy (LIS)

Non-MAGI Programs  Working Adults with Disabilities (WAwD)  Children’s Buy-in with Disabilities (CBwD)  Old Age Pension (OAP)  Old Age Pension Health Care Plan (OAP-HCP)  Breast and Cervical Cancer Program (BCCP)  LTC programs  Another class Page 8

Benefit Categories  1 through 7  Ranks groups of MA categories by overall benefit.  1 is highest benefit

Benefit Categories  1 for LTC  2 State plan Medicaid programs  3 Buy-in programs  4 QMB  5 Other MSP  6 HCP  7 LIS Page 9

MA Assistance Hierarchy  CBMS assessed eligibility for the highest benefit categories first.  SLMB is #40, 39 other categories are evaluated first. Page 10,11

MA Assistance Hierarchy Which program will CBMS display if someone was not eligible for any program? LIS Page 10,11

Review Which SSA programs come with Medicare? Retirement and SSDI

Review Which SSA program comes with Medicaid? SSI

Non-MAGI? What is different about these programs?

MA Hierarchy Again Your co-worker Ran EDBC and the case was approved for QMB, they ask you how to get a decision on OAP. What do you tell them?

Re-Visit Objectives: Can you?  Identify eligibility differences between MAGI and Non-MAGI.  Associate SSI, SSDI and SSA with Medicaid or Medicare appropriately.  Recognize what approval for lower level MA hierarchy categories means for other MA category decisions. Non-MAGI Overview Page 5 Goal: To gain further understanding of Medical Assistance programs, Social Security programs and how they relate.