Medicaid Alternative Care (MAC)

Created on: 
Jan 23 2017

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

What is Medicaid Alternative Care (MAC)?

MAC provides support services and respite to family caregivers when the care is provided to current recipient of a Categorically Needy or Alternative Benefit Plan (CN/ABP) Medicaid program who resides in an at home setting. For more information,  see the Apple Health Eligibility Manual-the WAC will be posted once policy updates their manual.

Who is eligible for Medicaid Alternative Care (MAC)?

To be eligible for MAC, a client must:

  • Reside in an at home sub-setting;
  • Be Age 55 or older;
  • Be a citizen or federally qualified alien;
  • Have a valid Social Security Number (SSN);
  • Meet Nursing Facility Level of Care;
  • Have income at or below the Special Income Level (SIL); and
  • Be on one of the following Categorically Needy or Alternative Benefit Plan (CN/ABP) medical programs to receive services:
  • L31 (SSI PACE or Institutional Hospice)
  • L32 (SSI Related PACE or Hospice)
  • N01 (MAGI-Parent/Caregiver)
  • N02 (MAGI-Transitional Medical)
  • N03 (MAGI- Pregnancy – Federal)
  • N05 (MAGI- New Adult)
  • N23 (MAGI – Pregnancy State)
  • R03 (Refugee Medical)
  • S01 (SSI Categorically Needy)
  • S02 (SSI Related Categorically Needy)
  • S08 (HWD)
  • S30 (Breast and/or Cervical Cancer Treatment Program)

There is no asset or resource test, no estate recovery and no participation connected with this program.

Services can only be provided in an at home setting and all calculations for the MAC program are calculated offline.

The MAC program does not generate any ACES letters.

Online Processing

How do I add Medicaid Alternative Care (MAC) services for an active client on a Categorically Needy or Alternative Benefit Plan (CN/ABP) Medical Program?

If a client meets the eligibility requirements for MAC services take the following steps:

  1. Update the following on the Case Actions page:
  • Benefit month field -  Select the month and year the client is found eligible for MAC services and click the Start Changes link.
  1. Add a Home and Community Based Service and complete the following field:
  • Type field - Select Medicaid Alternative Care (B).
  1. Click on Eligibility and then click the Commit Changes button to commit the data.

Mainframe Processing

How do I add Medicaid Alternative Care (MAC) services for an active client on a Categorically Needy or Alternative Benefit Plan (CN/ABP) Medical Program?

If a client meets the eligibility requirements for MAC services take the following steps:

  1. From the AMEN screen, update the following fields and <TRANSMIT>.
  • Selection field - Enter Option [R] - Interim/Hist Change.
  • AUID or Client ID field - Enter the [AUID or CLID].
  • Benefit Month (MM YY) field - Enter the [month and year] 
  1. On the INST screen, in the Home Community Based Service section:
  • HCBS Type field- Enter [B]-Medicaid Alternative Care (MAC).
  1. Call DONE and commit the data.

 

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