Continuous Eligibility for Categorically Needy Children's Medical

Created on: 
Aug 17 2016

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

Who is eligible to receive Categorically Needy (CN) Children's Medical?

Children who have been determined eligible for CN medical are eligible to receive a full 12 months of CN medical coverage regardless of changes in the circumstances or the household the child is associated with.

For more information see the following:

What Categorically Needy (CN) medical coverage groups are tracked?

ACES tracks each child's certification in the following CN medical coverage groups:

  • K01 - CN Long Term Care (LTC) - Family
  • L01 - CN LTC in a Medical Facility - Supplemental Security Income (SSI) Recipient
  • L02 - CN LTC in a Medical Facility - SSI Related
  • N11 - Modified Adjusted Gross Income (MAGI) Children's Medical - Federal
  • N13 - MAGI Children's Health Insurance Program (CHIP) - Federal
  • N31 - MAGI Children's Medical - State
  • N33 - MAGI CHIP - State
  • S01 - SSI Categorically Needy

Each recipient child in the above medical coverage groups are tracked for a 12-month potential continuous range which is based on the begin date of the certification period. The potential range end date is the child's begin date plus 11 months, it is not based on the number of months the client received coverage.

When is Modified Adjusted Gross Income (MAGI) Children's Health Insurance Program (CHIP) - Federal (N13) and MAGI CHIP - State (N33) coverage automatically authorized?

When a child is closed off an N13 or N33 Assistance Unit (AU) that does not result in continuous eligibility, the system continues to track continuous N13/N33 eligibility. If the child is reopened on medical during the 12 month tracking period, and the household's income exceeds 200% of the Federal Poverty Level, the MAGI Children's - Federal (N11) or MAGI Children's - State (N31) AU trickles to an active N13/N33 AU.

What happens to a child's continuous range when they are added to a Modified Adjusted Gross Income (MAGI) household?

When a child is added to a MAGI household and becomes an active recipient, the begin date of the tracking is the begin date on the new certification period for that child. A new potential continuous range is created for the added client(s) only and each added recipient child gets their own complete 12-month potential range.

Online Processing

How is Categorically Needy (CN) continuous medical eligibility tracked in ACES?

The system automatically tracks a child's 12-month continuous CN Medicaid coverage based on the begin date of the Assistance Units (AUs) certification period on the Children's Tracking CN Medicaid page.

How do I access the Children's Tracking CN Medicaid page?

The Children's Tracking CN Medicaid page can be accessed in the following ways in aces.online:

  1. On the Welcome Back page in aces.online, complete the following fields in the Quick Navigation section:
  • Select a Type of ID field - Select Client from the drop down menu.
  • Enter an ID field - Enter a [Client ID number].
  • Select a Page field - Select Children's Tracking CN Medicaid from the drop down menu and click Go.
  1. From the Summary page, select Children's Tracking CN Medicaid from the Details submenu.

What information is displayed on the Children's Tracking CN Medicaid page?

The Children's Tracking CN Medicaid page displays the following information:

  • AU ID field - The Assistance Unit (AU) number under which the client is receiving, or has received Categorically Needy (CN) Medicaid Coverage.
  • Range Start and Range End fields - The range start date plus 11 months calculates the range end date. Continuous range is 12 months regardless of the original AU certification period.
  • Premium Tier field - The premium Tier level a recipient is “locked” into.
  • Premium Tier End Date field - The date the Tier level is anticipated to end.
  • Cancelled Date field - The date the CN Medicaid range is no longer tracked and is not considered for continuous coverage.

How do I invalidate Continuous Eligibility Tracking (CTCN) in aces.online?

For more information on invalidating the CTCN for children's medical, see How do I invalidate Continuous Eligibility Tracking (CTCN) for Children's Washington Apple Health (WAH) Modified Adjusted Gross Income (MAGI) in aces.online?

Mainframe Processing

How is Categorically Needy (CN) continuous medical eligibility tracked in ACES?

The system automatically tracks a child's 12-month continuous CN Medicaid coverage based on the begin date of the Assistance Units (AUs) certification period on the CTCN screen.

How do I access the CTCN screen?

The CTCN screen can be accessed in the following ways:

  1. On the AMEN screen, complete the following fields:
  • Selection field - Enter [2] - Children's Tracking CN
  • Client ID field - Enter the [Client ID].
  1. From the CLLI screen, enter a [Y] in S field next to the client and press <F13>.

What information is displayed on the CTCN screen?

The CTCN screen displays the following information:

  • CN MEDICAID AU field - The Assistance Unit (AU) number under which the client is receiving, or has received Categorically Needy (CN) Medicaid Coverage.
  • Potential Continuous Range field - The range start date plus 11 months calculates the range end date. Continuous range is 12 months regardless of the original AU certification period.
  • Prem Tier Level field - The premium Tier level a recipient is “locked” into.
  • End Dt field - The date the Tier level is anticipated to end.
  • Removed field - The date the CN Medicaid range is no longer tracked and is not considered for continuous coverage.

The CTCN screen is an Inquiry only screen and is not part of the data collection screen flow. No fast path or remarks are allowed on the screen. Paging is allowed when more data exists with the most current tracked period appearing at the top of the list.

How do I invalidate Continuous Eligibility Tracking (CTCN)?

This feature is no longer available for mainframe processing. For more information, see Online Processing - How do I invalidate Continuous Eligibility Tracking (CTCN) in aces.online?

 

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