201 GENERAL INFORMATION (MAM) |
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When an individual requests medical assistance, determine whether the individual meets the requirements of any of the medical assistance programs administered by DHHS.
Medical assistance is available:
. under the adult program to individuals who are aged, blind, or physically or mentally disabled;
. under the MAGI-related categories: (Children's Medicaid [which includes Children with Severe Disabilities (CSD)], Expanded Children's Medicaid, Pregnant Women, Parents/Caretaker Relatives, Former Foster Care Child, and Family Planning Expansion Category;
. through the Medicaid for Employed Adults with Disabilities (MEAD) program;
. through Refugee Medical Assistance (RMA);
. through the Home Care for Children with Severe Disabilities (HC-CSD) program;
. through long-term care (LTC) services, which includes nursing facility (NF) and home and community-based care (HCBC) services; and
. through the Medicare Savings Programs (MSP) (QMB, SLMB/SLMB135, QDWI).
The following chart identifies the type of assistance provided by each program:
Programs |
Financial Assistance |
Medical Assistance |
Old Age Assistance (OAA) |
Yes |
Yes |
Aid to the Needy Blind (ANB) |
Yes |
Yes |
Aid to the Permanently and Totally Disabled (APTD) |
Yes |
Yes |
Medicaid for Employed Adults with Disabilities (MEAD) |
No |
Yes |
Qualified Medicare Beneficiary (QMB) |
No |
Limited |
Qualified Disabled and Working Individuals (QDWI) |
No |
Limited |
Specified Low-Income Medicare Beneficiary (SLMB) and SLMB135 |
No |
Limited |
Parents Caretaker Relative MA |
Yes |
Yes |
*Former Foster Care Child MA * |
*No |
Yes |
|
|
|
|
|
|
Children's Medicaid (CM) |
No |
Yes |
Expanded Children's Medicaid |
No |
Yes |
*Pregnant Women MA |
No |
Yes |
Family Planning Medical Assistance (FPMA) |
No |
Limited |
Refugee Medical Assistance (RMA) |
Yes |
Yes |
Individuals who meet the categorical requirements of either OAA, ANB, or APTD and who meet additional requirements relative to special living arrangements may be entitled to either a higher standard of need or expanded services.
Special Living Arrangements |
Financial Assistance |
Medical Assistance |
Residential Care Facility (RCF) |
Yes |
Yes |
Community Residence (including enhanced family care facilities) |
Yes |
Yes |
Nursing Facility (NF) |
No |
Yes |
Home and Community-Based Care for the Elderly and Chronically Ill (HCBC-ECI) |
Yes |
Yes |
Home and Community-Based Care for the Developmentally Disabled (HCBC-DD) |
Yes |
Yes |
Home and Community-Based Care for Individuals with an Acquired Brain Disorder (HCBC-ABD) |
Yes |
Yes |
Home and Community-Based Care for In-Home Support (HCBC-IHS) |
Yes |
Yes |
References: He-W 601.01(c), (h), & (i), He-W 601.02(m), He-W 601.05(d), (f), (q), & (z), RSA 167:6, 42 CFR 435.110, 42 CFR 435.116 - 42 CFR 435.118