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Published byHarold Cole Modified over 8 years ago
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Overview Expanding Foundations: Non-MAGI
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Group Expectations Stay PresentRespect each individual’s right to learnCritique ideas, not individualsOwn your own learningChallenge yourselfTake care of yourself Page 4
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Housekeeping Location of bathrooms Breaks and lunches Safety Computer use Food and drink Clean-up Training materials
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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.
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MAGI vs. Non-MAGI What do we remember from EF: MAGI?
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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
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Social Security Administration (SSA) Social Security Retirement Social Security Disability Insurance SSDI Medicare Supplemental Security Income SSI
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SSDI and SSA retirement Title II Work Quarters No Income and Resource Checks Funded by payroll tax Medicare Disabled or Retired (62+)
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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
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Non-MAGI Programs SSI related programs SSI Disabled Adult Child (DAC) Qualified Disabled Widow(er) (QDW) Pickle Page 8
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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)
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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
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Benefit Categories 1 through 7 Ranks groups of MA categories by overall benefit. 1 is highest benefit
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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
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MA Assistance Hierarchy CBMS assessed eligibility for the highest benefit categories first. SLMB is #40, 39 other categories are evaluated first. Page 10,11
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MA Assistance Hierarchy Which program will CBMS display if someone was not eligible for any program? LIS Page 10,11
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Review Which SSA programs come with Medicare? Retirement and SSDI
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Review Which SSA program comes with Medicaid? SSI
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Non-MAGI? What is different about these programs?
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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?
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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.
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