MA ABD Eligibility Results

Use this procedure to view the results for an ABD case for which eligibility has just been run. The applicable ABD programs are:

SSI Recipients Medicaid
ABD protected group full benefits
ABD 80% FPL group full benefits
Medicaid WORKS full benefits
ABD Hospice
ABD Institutionalized and 300% SSI
F&C Hospice
F&C Institutionalized and 300% SSI
MN - Aged, Blind, Disabled Medicaid spenddown
Qualified Medicare Beneficiaries (QMB)
Special Low-Income Medicare Beneficiaries (SLMB)
Qualified Individuals (QI)
Qualified Disabled Working Individuals (QDWI)

Process Steps:

The Wrap-up - Eligibility Summary page displays.

The Eligibility Summary page displays the results of the eligibility calculation, showing the details of the case’s eligibility or ineligibility. The unique Eligibility Determination Group (EDG) number, type of assistance (TOA), eligibility period, family unit size, potential co-payment, eligibility status, and eligibility determination date are also displayed. If the case has been certified the certification results will be displayed.

Review the Eligibility information as appropriate, including:

- EDG #
- Program / TOA
- Eligibility / Service Period
- Family Unit Size
- Potential Copay (Child Care)
- Net Benefit Amount
- Eligibility Result
- Eligibility Status
- Eligibility Determination Date
- Pending Reasons VCL Other

Click on the Eligibility / Service Period hyperlink to view the Eligibility Determination Group Summary results.

The Eligibility Determination Group Summary page displays.

- Review the information in the Case Information section as appropriate, including:
- - Case Name
  - Case #
  - Case Mode
  - Case Status
- Review the information in the EDG Information section as appropriate, including:
- - EDG #
  - Program / TOA
  - Eligibility / Service Period
  - Eligibility Result
  - Eligibility Status
  - Redetermination Date
  - Interim Report Date
- Review the information in the EDG Information section as appropriate, including:
- - Eligibility Begin Date
  - Eligibility End Date
  - Non Financial
  - Resource
  - Financial
  - Verification
  - Program Category (Child Care)
  - Patient Pay Amount (Institutionalized Individual only)
  - Spenddown Amount
  - Spenddown Met

The bottom section of the Eligibility Determination Group Summary page displays household members who were either included in the EDG or excluded from the EDG. The names of the household members are hyperlinked to further individual detail information.

Review the information in the Names section near the bottom of the page as appropriate, including:

- EDG
- Excluded
- Certified Group

A Certified Group status of "Y" indicates that the client was included in calculations for the type of assistance because they are potentially eligible. A Certified Group status of "N" indicates that the client is an EDG only member. Eligibility is not determined for EDG only members, but their income, assets, and other items may have factored into determinations for the Family Unit Certified Group.

- Relationship
- Aid Code
- Participation Status

Each household member is assigned one of the following participation statuses: Eligible Child, Included Adult, Included Child, Excluded Adult, or Excluded Child.

An Eligible Child is a person included in the EDG and eligible to receive services. A certified group member’s participation status will remain as Eligible Child even if the EDG is denied child care based on a financial requirement. However if the child is denied due a non-financial reason, the status will be changed to Included Child.

An Included Adult or Included Child is a person included in the EDG, but ineligible to receive services.

Countable Adult or Countable Child (Medical Assistance Only) a person included in the EDG (Family Unit), but ineligible to receive the assistance or benefits for the EDG Program.

An Excluded Adult or Excluded Child is a person excluded from participation in the EDG, and whose income, assets, and needs are not considered when determining eligibility for the EDG.

- Sanction
- Coverage

Coverage (Medical Assistance only) displays the coverage type (for example, Full Scope, Restricted / Emergency) of the Medical Assistance, the individual is eligible for.

Click on the Verification Checklist – Details page (VCL) and Other Pending Reasons page if applicable.

If there is pending verification checklist applicable for the Eligibility Determination Group (EDG), then the VCL link will be available for that EDG. Similarly if the EDG is pending for other Non-Financial and Financial reasons, then the link under Pending reasons will be enabled. If the Eligibility Result is not pending, the links under VCL and Other Pending reasons are NA.

Click on the Income tab to view the Medical Assistance – ABD Income Eligibility page.

If the Income tab is not active the eligibility process is not complete. Complete the Intake process and run and certify the eligibility results.

The Medical Assistance – ABD Income Eligibility page displays.

- Review the information in the Case Information section as appropriate, including:
- - Case Name
  - Case #
  - Case Mode
  - Case Status
- Review the information in the EDG Information section as appropriate, including:
- - EDG #
  - Program / TOA
  - Eligibility / Service Period
  - Eligibility Result
  - Eligibility Status
  - Redetermination Date
  - Interim Report Date
- Review the Total Self Employment Income.
- Review the Total Earned Income.
- Review the Total Unearned Income.
- Review the Deemed Spouse Income.
- Review the Deemed Parents Income.
- Review the Irregular Earned Income Exclusion.
- Review the Irregular Unearned Income Exclusion.
- Review the $20 Earned General Exclusion.
- Review the $20 Unearned General Exclusion.
- Review the Other Earned Income Exclusion.
- Review the Total Countable Income.
- Review the Assistance Unit Size.
- Review the EDG Income Limit.
- Review the Financial Eligibility Limit.

Click the Name hyperlink for any individual.
Click the Resource tab to view the Medical Assistance – Client Resource page for that individual.

- Review the information in the Case Information section as appropriate, including:
- - Case Name
  - Case #
  - Case Mode
  - Case Status
- Review the information in the EDG Information section as appropriate, including:
- - EDG #
  - Program / TOA
  - Eligibility / Service Period
  - Eligibility Result
  - Eligibility Status
  - Redetermination Date
  - Interim Report Date
- Review the information below as appropriate, including:
- - Real Property
  - Vehicle
  - Liquid Assets
  - Personal Property
  - Burial
  - Life Insurance
  - Total Countable Resources

Click the Name hyperlink for any individual.
Click the Resource tab to view the Medical Assistance – Client Resource Details page.

- Review the information in the Case Information section as appropriate, including:
- - Case Name
  - Case #
  - Case Mode
  - Case Status
- Review the information in the EDG Information section as appropriate, including:
- - EDG #
  - Program / TOA
  - Eligibility / Service Period
  - Eligibility Result
  - Eligibility Status
  - Redetermination Date
  - Interim Report Date
- Review the information below as appropriate, including:
- - Real Property Gross Value
  - Real Property Countable Value
  - Real Property Exclusion Reason
  - Vehicle Gross Value
  - Vehicle Countable Value
  - Vehicle Exclusion Reason
  - Liquid Assets Gross Value
  - Liquid Assets Countable Value
  - Liquid Assets Exclusion Reason
  - Personal Property Gross Value
  - Personal Property Countable Value
  - Personal Property Exclusion Reason
  - Burial Gross Value
  - Burial Countable Value
  - Burial Exclusion Reason
  - Life Insurance Gross Value
  - Life Insurance Countable Value
  - Life Insurance Exclusion Reason
  - Home / Mobile Home Gross Value
  - Home / Mobile Home Countable Value
  - Home / Mobile Home Exclusion Reason

Click the Deemed Spouse Income tab.

- Review the information in the Case Information section as appropriate, including:
- - Case Name
  - Case #
  - Case Mode
  - Case Status
- Review the information in the EDG Information section as appropriate, including:
- - EDG #
  - Program / TOA
  - Eligibility / Service Period
  - Eligibility Result
  - Eligibility Status
  - Redetermination Date
  - Interim Report Date
- Review the Total Self Employment Income.
- Review the Total Earned Income.
- Review the Total Unearned Income.
- Review the Non BD Child Allocation.
- Review the Total Non BD child(ren) in Household.
- Review the Total Non BD child(ren) in Allocation.
- Review the Total Income of Non-BD Child(ren).
- Review the Deeming Standard.
- Review the Deemed spouse Income.

Click the Deemed Parents Income tab.

- Review the information in the Case Information section as appropriate, including:
- - Case Name
  - Case #
  - Case Mode
  - Case Status
- Review the information in the EDG Information section as appropriate, including:
- - EDG #
  - Program / TOA
  - Eligibility / Service Period
  - Eligibility Result
  - Eligibility Status
  - Redetermination Date
  - Interim Report Date
- Review the Total Self Employment Income.
- Review the Total Earned Income.
- Review the Total Unearned Income.
- Review the Number of Parents(s) Deeming.
- Review the Non BD Child Allocation.
- Review the Total Non BD child(ren) in Household.
- Review the Total Non BD child(ren) in Allocation.
- Review the Total Income of Non-BD Child(ren).
- Review the $20 Earned General Exclusion.
- Review the Other Income Exclusion.
- Review the Living Allowance.
- Review the Number of BD child(ren) in household.
- Review the Deemed Parents Income.

Click the Resource tab to view the Medical Assistance – ABD Resource Eligibility page.

- Review the information in the Case Information section as appropriate, including:
- - Case Name
  - Case #
  - Case Mode
  - Case Status
- Review the information in the EDG Information section as appropriate, including:
- - EDG #
  - Program / TOA
  - Eligibility / Service Period
  - Eligibility Result
  - Eligibility Status
  - Redetermination Date
  - Interim Report Date
- Review the Real Property.
- Review the Vehicle.
- Review the Liquid Assets.
- Review the Burial.
- Review the Life Insurance.
- Review the Deemed Parents Resources.
- Review the Total Countable Resources.
- Review the Assistance Unit Size.
- Review the Resource Eligibility Limit.
- Review the Resource Eligibility Result.

Click the Resource tab to view the Medical Assistance – ABD Deemed Parents Resource page.

- Review the information in the Case Information section as appropriate, including:
- - Case Name
  - Case #
  - Case Mode
  - Case Status
- Review the information in the EDG Information section as appropriate, including:
- - EDG #
  - Program / TOA
  - Eligibility / Service Period
  - Eligibility Result
  - Eligibility Status
  - Redetermination Date
  - Interim Report Date
- Review the Parents Total Resources.
- Review the Number of Parent(s) Deeming.
- Review the Deemed Resource Standard.
- Review the Number of BD Child(ren) in Household.
- Review the Deemed Parents Resource.

Click Eligibility Summary.
The Wrap-up - Eligibility Summary page displays.
Click on Client Communication Form to generate a Client Communication Form.

The Child Care Program Communication Form button will be disabled when a case is either in Intake or Redetermination case action.

Click Next.
The MMIS Individuals page displays.

Results of the Procedure

The eligibility results are viewed for the ABD case which has just been run.

Updated: 10/03/2016