Children's Medically Needy Program (F99)

Created on: 
Jan 09 2018

See ACES Screens and Online Pages for an example of pages or screens used in this chapter.

Who processes F99 (Medically Needy (MN) Children with Spenddown) Assistance Units (AUs)?

F99 AUs are processed by Health Care Authority (HCA) users assigned to Region 9 in one of the following Modified Adjusted Gross Income (MAGI) Community Service Offices:

  • 181 - Houses MAGI AUs that belong to Region 1 geographical/zip catchment.
  • 182 - Houses MAGI AUs that belong to Region 2 geographical/zip catchment.
  • 183 - Houses MAGI AUs that belong to Region 3 geographical/zip catchment.

HCA users have the ability to screen in or reinstate F99 AUs if needed.

Who is eligible for F99 (Medically Needy (MN) Children with Spenddown) Medical?

Individuals who meet the criteria in the following WAC may be eligible for F99 medical coverage: Apple Health eligibility manual - WAC 182-505-0210 - Washington apple health - Eligibility for children.

Can a client receive F99 (Medically Needy (MN) Children with Spenddown) medical coverage while incarcerated?

When a client is active or approved under some medical coverage groups while incarcerated, they can still be eligible to receive medical assistance in a suspended status. For more information, see Suspended Medical – State Bill (SB 6430).

How long is the F99 (Medically Needy (MN) Children with Spenddown) certification period?

F99 assistance units default to a six-month certification period but can be shortened. For more information, see Apple Health eligibility manual – WAC 182-519-0110 Spenddown of excess income for the medically needy program.

Online Processing

How do I screen F99 (Medically Needy Children with Spenddown) medical?

To screen in a F99 Assistance Unit (AU) take the following steps:

  1. Follow the instructions in How do I screen an application for a client?    

How do I process a pending F99 (Medically Needy Children with Spenddown) Assistance Unit (AU)?

To process a pending F99, take the following steps:

  1. Go to the Case Actions page. For more information, see How do I access the Case Actions page in ACES 3G?
  2. Complete the interview following the steps in How do I initiate and complete an intake interview?
  3. Complete all other screens as needed following the instructions in the Interview chapter.
  4. After committing the interview data, follow the instructions in the Process Application Month chapter for all pending months.
  5. After all pending months have been processed; follow the instructions in the Finalize Application chapter to complete the F99 eligibility determination.

For more information on the spenddown process, see Apple Health for the Medically Needy and Spenddown.

How do I add a person to a F99 (Medically Needy Children with Spenddown) Assistance Unit (AU) when it's at M status?

Additional household members cannot be added to a spenddown AU at M status.

A new AU is needed for the change in household composition.

To add a person to an F99 AU, take the following steps:

  1. Manually close the current F99 AU following the instruction in the Online Processing - How do I manually close an Assistance Unit (AU) or client?
NOTE: Before manually closing the current F99 AU, review the base period and shorten if necessary. For more information, see Online Processing - How do I shorten a spenddown Assistance Unit (AU) base period?.
  1. Screen in a new F99 AU including the new AU member(s) and following the instructions in Online Processing - How do I screen F99 (Medically Needy Children with Spenddown) medical?
  2. Process the pending F99 AU following the instructions in Online Processing - How do I process a pending F99 (Medically Needy Children with Spenddown) Assistance Unit (AU)? 

How do I enter spenddown medical expenses for an F99 (Medically Needy Children with Spenddown) Assistance Unit (AU) in M status?

To enter medical expenses to meet the client’s spenddown liability on an F99 AU in M status, take the following steps:

  1. Follow the instructions in Spenddown - How do I enter medical expenses?
  2. After expenses have been added, follow the steps in Spenddown - How do I assign medical expenses and authorize spenddown?

How do I initiate an Eligibility Review on an F99 (Medically Needy Children with Spenddown) Assistance Unit (AU)?

To complete the eligibility review on an F99 AU take the following steps:

  1. Follow the instructions in the Eligibility Review chapter.

Eligibility reviews can be initiated on spenddown AUs in A - Active or M - MA Spenddown status.

Mainframe Processing

How do I screen F99 (Medically Needy Children with Spenddown) medical?

This function does not currently exist in ACES Mainframe.  For more information how to screen F99, see: Online Processing - How do I screen F99 (Medically Needy Children with Spenddown) medical?

How do I process a pending F99 (Medically Needy Children with Spenddown) Assistance Unit (AU)?

This function does not currently exist in ACES Mainframe.  For more information how to process F99, see: Online Processing - How do I process a pending F99 (Medically Needy Children with Spenddown) Assistance Unit (AU)?

How do I add a person to a F99 (Medically Needy Children with Spenddown) Assistance Unit (AU) when it's at M status?

This function does not currently exist in ACES Mainframe.  To add a person to an F99 AU, see Online Processing - How do I add a person to a F99 (Medically Needy Children with Spenddown) Assistance Unit (AU) when it's at M status?

How do I enter spenddown medical expenses for an F99 (Medically Needy Children with Spenddown) Assistance Unit (AU) in M status?

This function does not currently exist in ACES Mainframe.  To enter spenddown medical expenses for an F99, see:  Spenddown - How do I enter medical expenses?

How do I initiate an Eligibility Review on an F99 (Medically Needy Children with Spenddown) Assistance Unit (AU)?

This function does not currently exist in ACES Mainframe.  To initiate an Eligibility Review on an F99, see:  Online Processing - How do I initiate an Eligibility Review on an F99 (Medically Needy Children with Spenddown) Assistance Unit (AU)?

Complete the eligibility review on an F99 AU following the instructions in the Eligibility Review chapter.

 

See ACES Screens and Online Pages for an example of pages or screens used in this chapter.