Use this procedure to view the results for a case for which eligibility has just been run.
The Wrap-up - Eligibility Summary page displays.
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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:
Patient Pay Amount (Institutionalized Individual only)
Spenddown Amount (Non-ABD Medically Needy programs only)
Spenddown Met (Non-ABD Medically Needy programs only)
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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
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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
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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
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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.
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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 Notice Reasons tab to view the Notice Reasons.
The Notice Reasons 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 Client Information section as appropriate, including:
Eligibility Begin Date
Eligibility End Date
Review the information in the Notice Reason(s) for EDG section as appropriate.
Review the information in the Notice Reason(s) for Client(s) section as appropriate, including:
The Notice Reason(s) for all of the clients saying why they are not included in the certified group.
Click the Name hyperlink for any individual.
Click on the Income tab to view the Medical Assistance - Client Income Results page.
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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 - Client Income Results 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
Review the Total Self Employment.
Review the Total Earned Income.
Review the Total Unearned Income.
Review the Total Income.
Review the Other Deductions.
Click the Income Details tab to view the Medical Assistance – Client Income Details page.
The Medical Assistance – Client Income Results page displays.
Review the information in the Case Information section as appropriate, including:
Review the information in the EDG Information section as appropriate, including:
Review the Gross Self Employment Income.
Review the Self Employment Income.
Review the Self Employment Income Exclusion Reason.
Review the Gross Earned Income.
Review the Countable Earned Income.
Review the Earned Income Reason.
Review the Gross Unearned Income.
Review the Countable Unearned Income.
Review the Unearned Income Exclusion Reason.
Review the Total Income.
Review the Gross Other Deductions.
Review the Countable Other Deductions.
Review the Other Deduction Exclusion Reason.
Click Eligibility Summary.
The Wrap-up - Eligibility Summary page displays.
Click on Client Communication Form to generate a Client Communication Form.
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The Child Care Program Communication Form button will be disabled when a case is either in Intake or Redetermination case action. |
Click Next.
The Certification page displays.
Proceed to Certify Eligibility Results.
The eligibility results are viewed for the case which has just been run.
Updated 05/15/2015