MANUAL TRANSMITTAL
Arkansas Department of Human Services
Division of County Operations
Policy Directive
Issuance Number: MS 98-12
TEA 98-13
Medical Services Policy and
Transitional Employment Assistance Manual Issuance Date: 8-24-98
From: RuthWhitney, Director Expiration Date: Until Superseded
Subj: TEA Medicaid and Extended (Transitional) Medicaid
The purpose of this policy directive is to clarify a few areas of concern related to TEA Medicaid and Extended (Transitional) Medicaid.
TEA Medicaid
It is important to remember that TEA Medicaid and TEA cash assistance are not linked. A family member does not have to be eligible or have any interest in receiving TEA cash assistance in order to be eligible for TEA Medicaid. With the different income and resource methodologies in TEA, a family with deprived children may be eligible for TEA Medicaid and not be eligible for AFDC-MN.
EXAMPLE: Ms. Wright applies for Medicaid for herself and three children. Ms. Wright has no interest in applying for TEA cash. Although they are income eligible, they are not eligible for AFDC-EC because of a car with an equity value of $5000.00 ($5000.00 less the $1500.00 disregard equals $3500.00 which is over the $3200.00 MNRL). Ms. Wright and family are eligible for TEA Medicaid because one automobile is totally excluded in TEA, and they meet the income guidelines for TEA.
Extended (Transitional) Medicaid
County offices are doing such a great job of placing TEA recipients in employment quickly that several situations have occurred recently in which the family had been TEA recipients for only one or two months before the case was closed. The question was then raised as to whether the family was eligible for Extended (Transitional) Medicaid since they had not received at least three (3) months of either TEA cash or TEA Medicaid within the six (6) months preceding the first month of ineligibility.
It is important to remember that Extended Medicaid is based on TEA Medicaid eligibility, not eligibility for cash assistance. Families eligible for TEA Medicaid may also be eligible for retroactive Medicaid for up to three months prior to the date of application. Retroactive Medicaid eligible months will count toward three (3) of the six (6) months previously mentioned. Remember that to be eligible for a retroactive month, the family had to be income, resource and otherwise eligible, and have an alleged (doesn't have to be verified) medical expense.
• By considering the retro months, TEA Medicaid recipients quickly placed in employment may be eligible for the Extended Medicaid benefits. In light of this, retro Medicaid should always be considered in initial certification.
EXAMPLE: Ms. Smith applied for herself and her family on July 2nd and was certified for TEA cash and TEA Medicaid in July. In August, she went to work and became income ineligible for September. She had been determined eligible for retro TEA Medicaid for May. Therefore, since the family was eligible for and received three months of TEA Medicaid (May, July, and August) prior to the first month of ineligibility (September), the family is eligible for Extended Medicaid (category 25).
• A partial month of TEA Medicaid eligibility counts as one of the three months to be eligible for Extended Medicaid.
EXAMPLE: Mr. and Mrs. Greer apply for themselves and their family on June 29th and are certified for TEA cash assistance and TEA Medicaid on July 19th. The children meet deprivation due to Mr. Greer's unemployment. The Medicaid begin date was June 29th, and the cash assistance began effective July 1st. Mr. Greer became employed in August, with the first month of ineligibility as September. Since the Greer family received TEA Medicaid in three months (June, July, and August), they are eligible for Extended Medicaid.
• Remember that eligibility for TEA cash is not a requirement for Extended Medicaid.
EXAMPLE: Mr. Lovett applies for himself and his two daughters on August 5th. He states that he needs whatever help for which he may qualify. He states he has exhausted all resources. He was even forced to sell his cherished '86 Chevrolet Nova. He reports on August 16th, before certification, that he landed a job teaching. He would receive his first paycheck September 10th. It was determined that he was not eligible for TEA cash, but was eligible for TEA Medicaid for the months of May, June and August. Thus he is eligible for Extended Medicaid.
• It may be best if TEA Medicaid is the first category considered whenever a family with deprived children applies for Medicaid because of the possibility of qualifying for Extended (Transitional) Medicaid.
EXAMPLE: Ms. Dawson applied for Medicaid for herself and her two sons on June 1st. She drives a school bus for the local public schools. Her job ended for the summer in May and she receives her last paycheck on May 29th. She plans to return to her job at the end of August. She stated that she did not want TEA cash since she was returning to her job. Although the family was eligible for AFDC-EC, the county office decided to certify them in TEA Medicaid because of the potential eligibility for Extended Medicaid. The family was eligible for TEA Medicaid for the months of June, July and August with ineligibility beginning in September. Since they were eligible for TEA Medicaid for three months and lost eligibility due to employment, they qualified for Extended Medicaid.
Note: Eligibility for TEA Medicaid does not give the client eligibility for other supportive services. A client must be or have been a recipient of TEA cash in order to receive TEA child care benefits, work related expenses, etc.
We hope that this policy directive increases your understanding of TEA Medicaid and its relationship to Extended Medicaid. We also hope it will result in more newly certified TEA recipients being eligible for Extended Medicaid benefits if they go to work quickly, and therefore, both clients and workers will not be deterred from moving clients into employment quickly.
Inquiries to: Linda Greer, 682-8257
Jack Tiner, 682-8259