4-001.01A2 Eligibility for Transitional Medical Assistance (TMA)

ADC/MA clients are eligible for up to 12 months of TMA without a share of cost if all of the following are met:

  1. The case has earned income which results in ineligibility for a grant and/or ADC related medical assistance (or in conjunction with other factors results ineligibility for a grant and/or ADC related medical assistance);

    Note: The parent or needy caretaker relative or guardian or conservator must be in the household.

  2. The unit received a grant and/or ADC related medical assistance for which they were eligible (or did not receive a grant and/or ADC related medical assistance but met income and resource eligibility to receive a grant and/or ADC related medical assistance) in three of the last six months preceding ineligibility;
  3. The parent or needy caretaker relative or needy guardian or conservator is employed.

The unit is ineligible for TMA if it received a grant and/or ADC related medical assistance in one or more of the three qualifying months as a result of convicted fraud during the last six months before the beginning of the transitional period.

 

The unit must submit the required reports [see 468 NAC 4-001.01A2c(1)] in order to continue to receive TMA in the second six months. See 468-000-327 for the ADC Transitional Timeline.

There is no resource test while the unit is in TMA.

Note: The TMA unit may be subject to a premium beginning with Month 7. Failure to pay the required premium by the 21st of the following month will result in ineligibility for the month for which the premium was owed.

A family that was granted TMA eligibility before November 1, 2002, will have their total period of TMA reduced to a maximum of 12 months.

TMA Examples

TMA Fee Schedule

{2/14/09}

4-001.01A2a Eligible Family Members

4-001.01A2b Removed Family Members

4-001.01A2c Initial Six Months

4-001.01A2d Months 7 through 12

4-001.01A2e After Month 12