N-FOCUS uses the following priorities when determining which program/unit to place individual family members in.
1. AABD/MA - All aged, blind, or disabled family members are placed in an AABD/MA unit. An AABD/MA eligible couple is considered one unit if they are living together in the same household. See eligibility requirements in Title 469.
2. ADC/MA - All parents and dependent children who are economically deprived are placed in an ADC/MA unit. A dependent child is one who is age 0 through age 17, and an 18-year-old if s/he is a full-time student or an EF participant. See eligibility requirements in Title 468. Parent(s) included in a TMA unit where economic deprivation no longer exists are placed in an ADC/MA unit.
3. Ribicoff - All children age 0 through 20 who are not eligible for AABD/MA or ADC/MA, e.g., not blind/disabled, not economically deprived and not eligible as Poverty Level Children’s Medical. See eligibility requirements in Title 477, Chapter 3.
Note: The age of majority is 19.
Children Medical Assistance Programs that are based on the Federal Poverty Levels include children who are not eligible for AABD/MA, ADC/MA, Ribicoff, or who would be eligible for ADC/MA or Ribicoff but it is to the benefit of the family to place the child(ren) in a medical unit because of the budgeting advantage.
4. SEMAC - Unborns are eligible if family income equals 185 percent or less of the federal poverty levels found at 477-000-202.
5. EMAC - All children up to the age of one are eligible if the family income equals 150 percent or less of the federal poverty levels found at 477 NAC 4-001.02B.
6. MAC - All children from age 1 to age 5 or younger but not yet age 6 are eligible if the family income equals 133 percent of the federal poverty levels found at 477 NAC 4-001.02C.
7. SAM - All children ages 6 through 18 are eligible if the family income equals 100 percent or less of the federal poverty levels found at 477 NAC 4-001.02D.
All ADC/MED parent(s) and dependent children are placed in one ADC/MED unit, unless one of the following exceptions applies:
1. A parent or dependent child(ren) who is aged, blind, or disabled may be in an AABD/MA unit.
Note: If the aged, blind, or disabled individual is not receiving SSI and s/he has been a member of an ADC/MED unit that is in Transitional Medical Assistance or in 4 months of MA without SOC due to increased child/spousal support, the individual must remain in the ADC/MA unit until these benefits are exhausted UNLESS s/he would be eligible for an AABD/MA grant payment.
Workarounds:
1. To allow the 4 months of MA without SOC due to increased child/spousal support, you do not enter the child support increase until the four months are exhausted.
2. Medical Impairment needs to be end dated in order to leave the parent in ADC/MED.
2. A dependent child(ren) who meets the age requirement of the SAM, MAC, EMAC, or SEMAC programs is placed in that unit if the family has SOC and if all individuals are in the ADC/MA unit.
Note: Even though a child meets the age requirements of the SAM, MAC, EMAC, or SEMAC program if s/he was a member of an ADC/MA unit who is eligible for Transitional Medical Assistance or 4 months of MA without SOC due to increased child/spousal support, the child must remain in the MED-ADC unit until eligibility for these benefits is exhausted.
3. Parents may be included in the MED unit if they meet deprivation rules.
4. A child(ren) who does not meet the age requirement for ADC/MA, i.e., is age 18 and not in school or participating in EF. This child would be a separate medical unit.
(Rev. May 15, 2000)