24-005.05 Transitional Medicaid Assistance (TMA)

477 NAC 24-005.05

 

A client may receive up to 12 months of Transitional Medicaid without a share of cost if:

  1. The case has earned income which results in ineligibility for a grant and/or ADC related Medicaid.
    Note: The parent or needy caretaker relative or guardian or conservator must be in the household.
  2. The unit received, or met income and resource eligibility to receive, a grant and/or ADC related Medicaid for which they were eligible in three of the last six months preceding ineligibility;
  3. The parent or needy caretaker relative or needy guardian or conservator is employed.

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

TMA begins with the month of ineligibility for a grant and/or ADC related Medicaid.

If it was determined that the unit was ineligible for a grant, TMA shall be determined beginning with the first month in which the grant was erroneously paid.

The unit must submit the required reports in order to continue to receive TMA in the second six months. See Appendix 477-000-047 for the Transitional Timeline.

Note: The unit is ineligible for TMA if it received a grant and/or ADC related Medicaid 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.

If a family member, such as a parent or a child, returns to the home, grant or ADC related Medicaid eligibility for the whole family must be reviewed. If the returning family member is a responsible relative, the relative’s income must be used to compare the family’s income to the income guideline for the unit plus the responsible relative. If the family is ineligible for a grant or ADC related Medicaid, the returning family member is added to the TMA unit.

A child who is born or adopted while the family is receiving TMA is added to the TMA unit.

A parent who has been sanctioned while on grant for failure to cooperate with Employment First may be included in the TMA unit.

A parent who has been sanctioned for noncooperation with child support or TPL is not eligible until cooperation is resolved.

Note: Once a client is in TMA, s/he is not required to cooperate with program requirements such as Employment First, TPL, and child support.

 

24-005.05A If a Unit Member Leaves the Home

 

 

{01/2014}