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Program Codes
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Program Types
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Program Type Definitions
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Med Cvrg Group Code
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Medical Coverage Group Definition
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MA [Foster Care (FC) / Adoption Support (AS) / Juvenile Rehabilitation (JR)]
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1
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IV-E FC Federal Funded
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D01
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Title IV-E Foster Care Medical SSI Related CN
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D02
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Title IV-E Foster Care Medical Non-SSI Related
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MA [Foster Care (FC) / Adoption Support (AS) /Juvenile Rehabilitation (JR)]
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2
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Non IV-E FC State Funded
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D01
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Non IV-E Foster Care Medical SSI Related CN
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D02
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Non IV-E Foster Care Medical Non SSI Related
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MA [Foster Care (FC) / Adoption Support (AS) / Juvenile Rehabilitation (JR)]
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3
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IV-E AS Federal Funded
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D01
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Title IV-E Adoption Support Medical SSI Related CN
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D02
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Title IV-E Adoption Support Medical Non SSI Related
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MA [Foster Care (FC) / Adoption Support (AS) / Juvenile Rehabilitation (JR)]
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4
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Non IV-E Adoption Support State Funded
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D01
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Non IV-E State Funded Adoption Support Medical SSI Related CN
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D02
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Non IV-E State Funded Adoption Support Medical Non SSI Related
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MA [Foster Care (FC) / Adoption Support (AS) / Juvenile Rehabilitation (JR)]
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5
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Juvenile Rehabilitation
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D01
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SSI Related CN Medical Juvenile Rehabilitation
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D02
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Non SSI Related Medical Juvenile Rehabilitation
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Family Related MA
(E no longer valid)
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R, P
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Regular, Pregnant
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F02
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Transitional Medicaid
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Family Related MA
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F
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Regular Mixed Fed & SFA
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F02
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TANF Related
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Family Related MA
(No longer valid)
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G
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Pregnancy Mixed Fed & SFA
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F02
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TANF Related
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J
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Employable Mixed Fed & SFA
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F02
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TANF Related
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Family Related MA
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6
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Regular SFA Only
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F02
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TANF Related
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7
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Pregnancy SFA Only
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F02
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TANF Related
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Family Related MA
(No longer valid)
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8
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Employable SFA Only
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F02
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TANF Related
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Family Related MA
(E, employable, no longer valid)
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R, P
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Regular, Pregnant
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F03
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Post TANF Child / Spousal Support
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Family Related MA
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F
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Regular Mixed Fed & SFA
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F03
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TANF Related
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Family Related MA
(No longer valid)
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G
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Pregnancy Mixed Fed & SFA
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F03
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TANF Related
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J
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Employable Mixed Fed & SFA
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F03
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TANF Related
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Family Related MA
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6
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Regular SFA Only
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F03
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TANF Related
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7
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Pregnancy SFA Only
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F03
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TANF Related
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Family Related MA
(No longer valid)
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8
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Employable SFA Only
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F03
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TANF Related
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Family Related MA
(E, employable, no longer valid)
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R, P
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Regular, Pregnant
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F04
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TANF Related
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Family Related MA
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F
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Regular Mixed Fed & SFA
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F04
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TANF Related
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Family Related MA
(No longer valid)
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G
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Pregnancy Mixed Fed & SFA
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F04
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TANF Related
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J
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Employable Mixed Fed & SFA
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F04
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TANF Related
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Family Related MA
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6
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Regular SFA Only
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F04
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TANF Related
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7
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Pregnancy SFA Only
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F04
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TANF Related
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Family Related MA
(No longer valid)
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8
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Employable SFA Only
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F04
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TANF Related
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Family Related MA
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R
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Regular
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F05
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Newborns
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F06
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Categorically Needy (CN) for Children
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F07
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Children's Health Insurance Program (CHIP)
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Family Related MA
(No longer valid – 9/30/02)
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R
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Regular
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F08
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Undocumented Alien Children
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Family Related MA
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R
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Regular
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F09
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Undocumented Alien
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Family Related MA
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R, P
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Regular,
Pregnancy
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F10
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TANF Related
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F
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Regular
Mixed Fed & SFA
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F10
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TANF Related
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6
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Regular
SFA Only
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F10
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TANF Related
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7
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Pregnancy
SFA Only
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F10
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TANF Related
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Family Related MA
(Invalid as of 12/31/00)
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R
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Regular
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F20
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Family Medical Project
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Family Related MA
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R, P, E
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Regular, Pregnant, Employable
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F95
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Medically Needy Zero Spenddown
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F99
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Medically Needy Spenddown
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Medical Care Services MA
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U
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Unemployable
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G01
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Medical Care Services Unemployed
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R
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Regular
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G01
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Categorically Needy Medical – Child Under 19
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SSI Related Non-Institutional Alternate Living Facility MA
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A, B, D
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Aged, Blind, Disabled
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G03
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Categorically Needy ALF
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G95
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Medically Needy Zero Spenddown ALF
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G99
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Medically Needy with Spenddown ALF
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Medically Indigent MA
(Invalid as of 07/01/2003)
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R
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Regular
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M99
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Medically Indigent
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Pregnant MA
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P
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Pregnant
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P02
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Pregnant 185% + Postpartum Extension
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P04
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Undocumented Alien Pregnant Woman
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P05
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Family Planning Extension
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P99
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Medically Needy Pregnant Woman + Postpartum Extension
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Pregnant MA
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P
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Family Planning
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P06
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Take Charge Family Planning Service Only
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Psychiatric Indigent Inpatient MA
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R
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Regular
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M99
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Psychiatric Indigent Inpatient
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Refugee MA
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R
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Regular
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R02
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Transitional 4 Month Extension
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R03
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Refugee Categorically Needy
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SSI Related MA
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A, B, D
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Aged, Blind, Disabled
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S01
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SSI Recipient
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M
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Aged with Cash Payment
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S01
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SSI Recipient
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N
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Blind with Cash Payment
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S01
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SSI Recipient
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O
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Disabled with Cash Payment
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S01
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SSI Recipient
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A, B, D
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Aged, Blind, Disabled
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S02
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ABD Categorically Needy
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A, B, D
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Aged, Blind, Disabled
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S03
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Qualified Medicare Beneficiary (QMB) - Medicare Cost Sharing
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A, B, D
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Aged, Blind, Disabled
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S04
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Qualified Disabled Working Individual (QDWI) - Medicare Cost Sharing
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A, B, D
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Aged, Blind, Disabled
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S05
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Special Medicare Beneficiary (SLMB) - Medicare Cost Sharing
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A, B, D
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Aged, Blind, Disabled
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S06
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Expanded Special Medicare Beneficiary (ESLMB) - Medicare Cost Sharing
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A, B, D
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Aged, Blind, Disabled
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S07
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Undocumented Alien
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HWD
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A, B, D
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Aged, Blind, Disabled
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S08
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CN - Requires Premium Payment by Client
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SSI Related MA
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A, B, D
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Aged, Blind, Disabled
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S95
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Medically Needy - Zero Spenddown
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S99
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Medically Needy - with Spenddown
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ADATSA (Medical Assistance)
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W
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Treatment
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W02
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ADATSA Medical Care
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Z
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Shelter
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W01
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ADATSA Medical Care
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DETOX
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I
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DETOX - Hospital Payment Only
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W03
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DETOX
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Home & Community Based Waiver MA
(Invalid as of 02/01/2011)
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A, B, D
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Aged, Blind, Disabled
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C01
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Categorically Needy Home & Community Based Waiver (COPES, CAP, OBRA, and Hospice)
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M
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Aged with Cash Payment
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C01
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Categorically Needy Home & Community Based Waiver (COPES, CAP, OBRA, and Hospice)
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N
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Blind with Cash Payment
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C01
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Categorically Needy Home & Community Based Waiver (COPES, CAP, OBRA, and Hospice)
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O
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Disabled with Cash Payment
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C01
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Categorically Needy Home & Community Based Waiver (COPES, CAP, OBRA, and Hospice)
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A, B, D
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Aged, Blind, Disabled
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C95
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Hospice Services No Spenddown
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C99
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Hospice Services with Spenddown
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Family Long Term Care MA
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R, K, P
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Regular, Kids, Pregnant
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K01
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Categorically Needy Family Long Term Care
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F, G, 6, 7
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See F04 MA Cvrg. Grps. for Prgm. Type Description
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K01
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Categorically Needy Family Long Term Care
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Family Long Term Care MA
(No longer valid)
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J
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Kids Mixed Fed & SFA
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K01
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Categorically Needy Family Long Term Care
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8
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Kids - SFA Only
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K01
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Categorically Needy Family Long Term Care
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Family Long Term Care MA
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R, K, P
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Regular, Kids, Pregnant
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K03
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Undocumented Alien Family Long Term Care
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F, G, 6, 7
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See F04 MA Cvrg. Grps. for Prgm. Type Description
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K03
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Undocumented Alien Family Long Term Care
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Family Long Term Care MA
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J
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Kids Mixed Fed & SFA
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K03
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Undocumented Alien Family Long Term Care
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8
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Kids - SFA Only
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K03
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Undocumented Alien Family Long Term Care
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Family Long Term Care MA
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R, K, P
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Regular, Kids, Pregnant
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K95
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Family Long Term Care Zero Spenddown
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F, G, 6, 7
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See F04 MA Cvrg. Grps. for Prgm. Type Description
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K95
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Family Long Term Care Zero Spenddown
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Family Long Term Care MA
(No longer valid)
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J
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Kids Mixed Fed & SFA
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K95
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Family Long Term Care Zero Spenddown
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8
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Kids - SFA Only
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K95
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Family Long Term Care Zero Spenddown
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Family Long Term Care MA
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R, K, P
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Regular, Kids, Pregnant
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K99
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Family Long Term Care with Spenddown
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F, G, 6, 7
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See F04 MA Cvrg. Grps. for Prgm. Type Description
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K99
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Family Long Term Care with Spenddown
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Family Long Term Care MA
(No longer valid)
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J
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Kids Mixed Fed & SFA
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K99
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Family Long Term Care with Spenddown
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8
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Kids - SFA Only
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K99
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Family Long Term Care with Spenddown
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Long Term Care SSI Related MA
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A, B, D
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Aged, Blind, Disabled
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L01
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SSI Long Term Care
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M
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Aged with Cash Payment
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L01
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SSI Long Term Care
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O
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Disabled with Cash Payment
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L01
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SSI Long Term Care
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Home & Community Based Waiver MA
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A, B, D
M, N, O
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Aged, Blind, Disabled
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L21*
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SSI Long Term Care
Categorically Needy Home & Community Based Waiver (COPES, DDD, and Hospice)
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Home & Community Based Waiver MA
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M, N, O
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Aged, Blind, Disabled
With Cash Payment
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L21*
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SSI Long Term Care
Categorically Needy Home & Community Based Waiver (COPES, DDD, and Hospice)
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Home & Community Based Waiver MA
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A, B, D
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Aged, Blind, Disabled
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L22*
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Categorically Needy Home & Community Based Waiver (COPES, DDD, and Hospice)
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State Funded Long Term Care
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A, B, D
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Aged Blind, Disabled
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L24
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State Funded Long Term Care at home or Alternate Living Facility
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Long Term Care SSI Related MA
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A, B, D
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Aged, Blind, Disabled
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L02
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Categorically Needy Long Term Care
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L04
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State Funded Long Term Care in facility or hospital
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L95
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Long Term Care – No Spenddown
Hospice MN
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L99
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Long Term Care with Spenddown
Hospice MN
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Medically Needy Hospice – Institutional
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A, B, D
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Aged, Blind, Disabled
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L95*
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MN Hospice – No Spenddown
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L99*
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MN Hospice – with Spenddown
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Breast and Cervical Cancer Treatment Program (BCCTP)
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R
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Regular
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S30
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Categorically Needy
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