Appendix 1 - Institutional Program and Coverage Groups
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Appendix 1 - Institutional Program and Coverage Groups

Revised October 28, 2007

Purpose:

INSTITUTIONAL PROGRAM AND COVERAGE GROUPS

PROGRAM

INSTITUTIONAL PROGRAM

COVERAGE GROUP
TANF Related* CN - Categorically Needy Family Long Term Care K01
 

Undocumented Alien Family Long Term Care

 K03
  MN - Family Long Term Care Zero Spenddown K95
  MN - Family Long Term Care with Spenddown K99
SSI Related CN - Receives SSI in Medical Institution L01
 

CN - Gross income at or below 300 % of the FBR.  (Medicaid SIL) residing in a medical institution.

 

 L02
  Undocumented Alien Long Term Care residing in a medical institution. L04
  MN - Long Term Care Zero Spenddown. Residing in a medical institution.  Income over 300% of the FBR (Medicaid SIL) and under the state rate.  L95
  MN - Long Term Care with Spenddown residing in a medical institution.  Income over the state rate and under the private rate.  L99
SSI Related CN-Waiver or Hospice.  Income under 300% of the FBR (Medicaid SIL) C01
SSI Related

MN- Hospice institutional no spenddown.   Income over 300% of the FBR, under the state rate. 

(institutional = residing in a medical institution)

 C95
SSI Related MN- Hospice with Spenddown. Income over 300% of the FBR, over the state rate. C99

  • TANF Related clients not receiving benefits prior to institutionalization are approved under a K coverage group. Those receiving benefits prior to institutionalization remain under an F or P coverage group, unless the client is expected to remain out of the home for more than 90 days.

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Modification Date: October 28, 2007
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