Eligible Populations. The Demonstration will be available to individuals who meet all of the following criteria: • Age 21 and older at the time of enrollment; • Entitled to benefits under Medicare Part A and enrolled under Medicare Parts B and D, and receiving full Medicaid benefits; and • Enrolled in the Medicaid Aid to the Aged, Blind, and Disabled (AABD) category of assistance. Eligible populations include: • Beneficiaries who meet all other Demonstration criteria and are in the following Medicaid 1915(c) waivers: o Persons who are Elderly; o Persons with Disabilities; o Persons with HIV/AIDS; o Persons with Brain Injury and o Persons residing in Supportive Living Facilities. • Individuals with End Stage Renal Disease (ESRD) at the time of enrollment. The following populations will be excluded from enrollment: • Individuals under the age of 21; • Individuals receiving developmental disability institutional services or who participate in the HCBS waiver for Adults with Developmental Disabilities; • The Medicaid Spend-down population; • Beneficiaries in the Illinois Medicaid Breast and Cervical Cancer program; • Individuals enrolled in partial benefit programs; and • Individuals enrolled in both Medicare and Medicaid who have Comprehensive Third Party Insurance. Medicare-Medicaid beneficiaries who are in Medicare fee-for-service and meet the eligibility criteria above will be eligible for Passive Enrollment beginning January 1, 2014, unless they elect to opt out of the Demonstration, as discussed in C.2 below. Those beneficiaries who are enrolled in a Medicare Advantage plan that is operated by the same parent organization that operates a Demonstration Plan will also be eligible for Passive Enrollment into the Demonstration Plan operated by the same parent organization beginning January 1, 2014. Eligible beneficiaries enrolled in a Medicare Advantage plan that is operated by a parent organization that is not offering a Demonstration Plan may enroll into the Demonstration if they elect to disenroll from their current Medicare Advantage plan.
Eligible Populations. All residents living within the coalition target area as defined in this Contract.
Eligible Populations. This demonstration affects mandatory and optional Medicaid state plan populations as well as populations eligible for benefits only through the demonstration. Table A at the end of section IV of the STCs shows each specific group of individuals; under what authority they are made eligible for the demonstration; the name of the eligibility and expenditure group under which expenditures are reported to CMS and the budget neutrality expenditure agreement is constructed; and the corresponding demonstration program under which benefits are provided. Eligibility is determined based on an application by the beneficiary or without an application for eligibility groups enrolled based on receipt of benefits under another program. XxxxXxxxxx defines the age of a dependent child for purposes of the parent/caretaker relative coverage type as a child who is younger than age 19. A caretaker relative is eligible under this provision only if the parent is not living in the household. Retroactive Eligibility. Retroactive eligibility is provided in accordance to STC 50 Table F. Calculation of Financial Eligibility. Financial eligibility for demonstration programs is determined by comparing the family’s Modified Adjusted Gross Income (MAGI) with the applicable income standard for the specific coverage type, with the exception of adults aged 19 and above who are determined eligible on the basis of disability and whose financial eligibility is determined as described below. MAGI income counting methodologies will also be applied to disabled adults in determining eligibility for MassHealth Standard and CommonHealth; however, household composition for disabled adults will always be determined using non-tax filer rules, regardless of whether the individual files income taxes or is claimed as a dependent on another person’s income taxes. In determining eligibility and making related calculations of deductibles and cost sharing for MassHealth Standard and CommonHealth for disabled adults, the Commonwealth may consider state veteran annuity as non-countable income as described below, and apply the five percent income disregard that is also applied to non-disabled adults. Section 6b of Chapter 115 of Massachusetts General Law authorizes a state veteran annuity payment to eligible disabled veterans and surviving Gold Star parents and spouses who have lost their child or spouse in combat. Except as described in the next sentence, the Commonwealth may consider such payment as non-countab...
Eligible Populations. This demonstration affects mandatory and optional Medicaid state plan populations as well as populations eligible for benefits only through the demonstration. Table A at the end of section IV of the STCs shows each specific group of individuals; under what authority they are made eligible for the demonstration; the name of the eligibility and expenditure group under which expenditures are reported to CMS and the budget neutrality expenditure agreement is constructed; and the corresponding demonstration program under which benefits are provided. Attachment A provides a complete overview of MassHealth coverage for children, including the separate title XXI CHIP program, which is incorporated by reference. Eligibility is determined based on an application by the beneficiary or without an application for eligibility groups enrolled based on receipt of benefits under another program. XxxxXxxxxx defines the age of a dependent child for purposes of the parent/caretaker relative coverage type as a child who is younger than age 19. A caretaker relative is eligible under this provision only if the parent is not living in the household.
Eligible Populations. Beneficiaries with one chronic condition and at risk of developing another are eligible for the State’s approved health home SPA #13-08, as summarized below:
i. Chronic Conditions: The applicable chronic conditions for eligibility are: mental health condition, substance use disorder, asthma, diabetes, heart disease, cancer, cerebrovascular disease, coronary artery disease, dementia or Alzheimer’s disease, intellectual disability or disease, HIV/AIDS, renal failure, chronic respiratory conditions, neurological disease, gastrointestinal, hematological and musculoskeletal conditions.
Eligible Populations. The programs conducted by the parties to this agreement have overlapping populations and distinct target groups for specific services within eligible populations. The following descriptions are set out in order to define populations that may be impacted by this agreement.
Eligible Populations. This demonstration affects mandatory and optional Medicaid state plan populations as well as populations eligible for benefits only through the demonstration. Table A at the end of section IV of the STCs shows each specific group of individuals; under what authority they are made eligible for the demonstration; the name of the eligibility and expenditure group under which expenditures are reported to CMS and the budget neutrality expenditure agreement is constructed; and the corresponding demonstration program under which benefits are provided. Attachment A provides a complete overview of MassHealth coverage for children, including the separate title XXI CHIP program, which is incorporated by reference. Eligibility is determined based on an application by the beneficiary or without an application for eligibility groups enrolled based on receipt of benefits under another program. XxxxXxxxxx defines the age of a dependent child for purposes of the parent/caretaker relative coverage type as a child who is younger than age 19. A caretaker relative is eligible under this provision only if the parent is not living in the household. Retroactive Eligibility. Retroactive eligibility is provided in accordance to Table D. Calculation of Financial Eligibility. Financial eligibility for demonstration programs is determined by comparing the family’s Modified Adjusted Gross Income (MAGI) with the applicable income standard for the specific coverage type, with the exception of adults aged 19 and above who are determined eligible on the basis of disability and whose financial eligibility is determined as described below. MAGI income counting methodologies will also be applied to disabled adults in determining eligibility for MassHealth Standard and CommonHealth; however, household composition for disabled adults will always be determined using non-tax filer rules, regardless of whether the individual files income taxes or is claimed as a dependent on another person’s income taxes. In determining eligibility for MassHealth Standard and CommonHealth for disabled adults, the Commonwealth will apply the five percent income disregard that is also applied to non-disabled adults.
Eligible Populations. All residents living within the Coalition Program Service Area as defined in this Contract
Eligible Populations. 2.3.2.1. The Contractor shall cover all full-benefit Eligible Beneficiaries, including those who are:
2.3.2.1.1. Age 21 and older at the time of enrollment;
2.3.2.1.2. Entitled to benefits under Medicare Part A and enrolled under Medicare Parts B and D, and receiving full Medicaid benefits. This includes individuals enrolled in the Elderly or Disabled with Consumer Direction (EDCD) Waiver and those residing in nursing facilities (NF); and,
2.3.2.1.3. Residing in a CCC area.
2.3.2.2. DMAS shall exclude Enrollees who meet at least one of the exclusion criteria listed below:
Eligible Populations. Subtitle C of Title IV of the XxXxxxxx-Xxxxx Home- less Assistance Act. 24 CFR part 583 ........................................................ • States • Units of general local government • Special purpose units of government such as Public housing agencies (PHAs) • Private non-profit organizations • CMHCs that are public non-profit organizations • Permanent Housing for Persons with Disabilities • Safe xxxxxx • Rehabilitation • Leasing • Operating Costs • Chronically Homeless Persons Subtitle F of Title IV of the XxXxx- xxx-Xxxxx Homeless Assistance Act. 24 CFR part 582. • States • Units of general local govern- ment • PHAs • Tenant-based • Sponsor-based • Project-based without Rehabili- tation • Rental assistance • Chronically Homeless Persons HUD ELIGIBLE APPLICANTS AND ACTIVITIES CHART—Continued Elements Supportive housing Shelter plus care Term of Assistance ..................................................... 3 years ....................................................................... 5 years. 1 Homeless prevention activities are statutorily ineligible under these programs. Persons at risk of homelessness are statutorily ineligible for as- sistance under these programs.
