| 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 |
| |
State-funded CN scope of care in a nursing facility for non-citizens. Limited funding for 45 slots. Requires a pre-approval by ADSA HCS HQ |
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 DDD or HCS CN Waiver |
CN-Waiver or Hospice. Income under 300% of the FBR (Medicaid SIL) |
L22 |
| SSI Related - Hospice |
MN- Hospice institutional no spenddown. Income over 300% of the FBR, under the state rate.
(institutional = residing in a medical institution) Nursing Facility or Hospice Care Center
|
L95 |
| SSI Related |
MN- Hospice with Spenddown. Income over 300% of the FBR, over the state rate. |
L99 |
| SSI DDD or HCS CN Waiver |
CN-Receives DDD or HCS Waiver and is an SSI recipient. New medical coverage group effective 2/1/2011 |
L21 |
| SSI related stated funded HCS services for non-citizens in home or residential |
State-funded CN scope of care in a home setting or residential. Limited funding for 45 slots. Requires a pre-approval by ADSA HCS HQ |
L24 |
