Alien Medical
DSHS Home Page
 
Search     for:


DSHS Home    Acronyms    Alerts    Screens    WAC Number Index    WCCC

Alien Medical


Revised September 13, 2013





Alien Emergency Medical (F09)

 

Children's Health Program (F08) (In Children’s Medical)

 

Nursing Facility (L04)

 

State Funded LTC – SSI Related for Non-citizen Clients at Home or Alternate Living Facility (L24)

 

SSI Related Alien Emergency Medical (S07)

 

Undocumented Alien Pregnancy Medical (P04) (In Pregnancy Medical)

 


Alien Emergency Medical (F09)


NOTE:

As a result of implementation of the Affordable Care Act (ACA), effective with applications received on or after 10/01/2013 this medical program is no longer valid. Any current active AUs with this medical coverage type will continue through the AUs current certification period. Clients would then need to apply for medical through the healthplanfinder.

 

For more information about how to update the Alien Emergency Medical information for programs after 10/1/13, see MAGI Alien Medical programs section.


     

Processing Alternative

Medical

F09

 

Who is eligible to receive F09 medical?

 

How long is the certification period?

 

How do I screen F09 medical?

 

How do I process a pending F09 AU?

 


Who is eligible to receive F09 medical?

 

·         Undocumented aliens who are ineligible for any other medical program due to citizenship or alien status and meet the criteria in EAZ Manual – WAC 388-438-0110 The Alien Emergency medical (AEM) program.

 

How long is the certification period?

 

·         The certification periods for AEM:

o        Cannot be more than 12 months for non-spenddown AUs

o        Cannot be less than 1 month and no more than 6 months for spenddown AUs

o        Won't be synchronized with other related AUs

o        Won't continue beyond the end date when a review is initiated or received but not completed  

·         For more information, see ·EAZ Manual – Emergency Assistance - Alien Medical Program (AMP)

 

How do I screen F09 medical?

 

1.      From the Welcome Back page in aces.online, click the Screen New Application link at the top of the page.

 

2.      On the Applicant page:

 

o        Enter the applicant’s (head of household) name in the Applicant Name field.

 

o        Enter applicant’s residential address in the Residential Address field.

 

o        If applicant has a mailing address, uncheck the box next to Mailing Address and enter the applicant’s mailing address.

 

o        Click the Next button.

 

3.      On the Address Validation page:

 

o        Make sure applicant’s address is validated or validation is skipped if needed.

 

o        Click the Next button.

 

4.      Complete the address validation process. 

 

o        See Screening – aces.online, Address Validation for additional instructions on this process.

 

5.      On the Programs page:

                                            

o        Click the checkbox next to Medical.

 

o        Click the Next button.

 

6.      On the Finalize page:

 

o        Click on Specify Program button.

 

o        From the Program drop-down list, select Medical Assistance (MA).

 

o        From the Medical Coverage Group drop-down list, select Non-Citizen Family Related CN Emergency Medical (F09).

 

o        Click the Next button.

 

o        Enter the application date. (This is the date the client entered the hospital.)

 

o        Click the Commit button to commit the screening data.

 

How do I process a pending F09 AU?

 

To process a pending F09 AU take the following steps:

 

1.      Select AMEN, Option O – Interview.

 

2.      On the STAT screen, complete the Finl Resp fields as follows:

 

o        [PN] – Applicant

 

o        [SP]Spouse (if spouse in the home)

 

o        [SC]SSI Child/Child of SSI Related Parents/Child used to determine household size for any documented or undocumented children.

 

3.      On the ALAS screen, in the Alien Medical section:

 

o    Enter the [HCA Medical Consultant or ADSA Headquarter staff] approval source code in the Approv source:field.

 

o    Enter the [approval period begin date] as provided by the HCA Medical Consultant or ADSA Headquarter staff in the Approv Begin field.

 

o    Enter the [approval period end date] as provided by the HCA Medical Consultant or ADSA Headquarter staff in the Appov End field.

 

4.      Complete the interview following the instructions in the Interview chapter.

 

5.      After committing the interview data, follow the instructions in the Process Application Month chapter for all pending months.

 

6.      After all pending months have been processed; follow the instructions in the Finalize Application chapter to complete the F09 eligibility determination.

 


MODIFIED ADJUSTED GROSS INCOME (MAGI) ALIEN MEDICAL PROGRAMS

What are the new MAGI Alien Medical coverage groups?

Who processes the MAGI Alien Medical programs?

 

How do I process a pending MAGI Alien Medical program?


What are the new MAGI Alien Medical coverage groups?

 

·        As a result of the implementation of the Affordable Care Act (ACA), the following MAGI Alien Medical Coverage groups are in effect with applications received 10/1/2013:

 

o   Alien Emergency Medical Parent/Caretaker (N21)

 

o   Adult Alien Emergency Medical (N25)-(This program begins 01/01/2014)

 

Who processes the MAGI Alien Medical programs?

 

·        MAGI Alien Medical AUs belong to Health and Community Services (HCA) and can only be processed by an HCA or HCS user.

 

·        MAGI AUs are in Region 9 and are assigned to one of the following CSOs.

 

o   181- Houses MAGI AUs that belong to Region 1 geographical/zip catchment

o   182- Houses MAGI AUs that belong to Region 2 geographical/zip catchment

o   183- Houses MAGI AUs that belong to Region 3 geographical/zip catchment

 

 

How do I process a pending MAGI Alien Medical program?

 

·        To process a pending MAGI Alien Medical program HCA/HCS users need to take the following steps:

 

1.     In aces.online from the Welcome back page enter the client id in the Enter an ID field.

 

2.     From the Client>>Summary page select the AEM MAGI AU.

 

3.     From the Assistance Unit>>Summary page go to Details and select Demographics.

 

4.     At the bottom of the demographics page click on the update link that displays when there is a pending AEM N21 or N25 AU and enter the following information:

 

o   Alien Medical Emergency Indicator = “Y”

o   Alien Medical Approval Source Code – (H-HCA Medical Consultant Approved, A-ADSA Approved, or  N- Referral Not Approved)

o   Approval begin and Approval End Dates. 

 

Once the fields have been updated, HCA/HCS users must access the application for AEM in the Washington Healthplanfinder and initiate a call to Eligibility Service to either approve or deny the AU.


SSI Related Alien Emergency Medical (S07)

             

Who is eligible for S07 medical?

 

How long is the certification period?

 

How do I screen S07 medical?

 

How do I process a pending S07 AU?

 

How do I open coverage for a non-citizen receiving LTC services in a Residential setting?

 


Who is eligible for S07 medical?

 

·         Undocumented aliens with a medical emergency and who are SSI-related (aged, blind, or disabled) may be eligible to receive S07 (Alien SSI Related Emergency Medical) medical coverage.

 

·         See EA-Z Manual - Emergency Assistance Programs WAC 388-438-0110

 

How long is the certification period?

 

·         The certification periods for AEM:

o        Cannot be more than 12 months for non-spenddown AUs

o        Cannot be less than 1 month and no more than 6 months for spenddown AUs

o        Won't be synchronized with other related AUs

o        Won't continue beyond the end date when a review is initiated or received but not completed

·         For more information, see ·EAZ Manual – Emergency Assistance - Alien Medical Program (AMP)

 

How do I screen S07 medical?

 

·         S07 should be screened initially as an S02 AU; it trickles to S07 when the AU is finalized. See Trickle and Sprout - ABD SSI Related track.

 

·         See How do I screen an S02 AU?

 

·         Include all immediate family members in the household/AU to ensure proper allocation/deeming of income.

 

How do I process a pending S07 AU?

 

·         To process a pending S02/S07 AU, take the following steps:

 

1.      From the AMEN, access the pending AU via Option O – Interview.

 

2.      On the STAT screen, complete the Finl Resp field as follows:

 

o        [PN] – for applicant

 

o        [SP] – for spouse (Ineligible Spouse)

 

o        [SC] – for children (Used to determine household size; Documented or Undocumented)

 

3.      On the DEM2 screen:

 

o        Enter [U – Undocumented Alien] in the Citizenship field

 

o        Enter [N - No] in the Qualified Alien field.

 

o        Enter the appropriate [disability code] in the Disability/Incapacity field if the client is disabled. See <F1> Help.

 

4.      On the ALAS screen, in the Alien Medical section:

 

o        Enter the [HCA Medical Consultant or ADSA Headquarter staff] approval source code in the Approv source: field.

o        Enter the [approval period begin date] as provided by the HCA Medical Consultant or ADSA Headquarter staff in the Approv Begin field.

o        Enter the [approval period end date] as provided by the HCA Medical Consultant or ADSA Headquarter staff in the Appov End field.

 

5.      For SSI related individuals, enter a [1] or [2] under the ABD Area field on the MISC screen. See <F1> Help.

 

6.      After committing the interview data, follow the instructions in the Process Application Month chapter for all pending months.

 

7.      After all pending months have been processed, follow the instructions in the Finalize Application chapter to complete the S07 eligibility determination.

 

How do I open coverage for a non-citizen receiving LTC services in a residential setting?

 

·            To open coverage for a non-citizen received LTC services in a residential setting, follow the procedures in How do I screen L24 medical?

 

 

 

Modification Date: September 13, 2013