1306 Medical Assistance
User Manual: 1306-Medical-Assistance
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DEPARTMENT OF HUMAN RESOURCES
FAMILY INVESTMENT ADMINISTRATION TEMPORARY CASH ASSISTANCE
MANUAL
MEDICAL ASSISTANCE 1306
COMAR
07.03.03.07 SUPPORTIVE
SERVICES 1300
REVISED AUGUST 2008
Page 1
1306.1 MA CATEGORIES
A. Family and Children (FAC) provides coverage for parents or caretaker relatives
other than parents and their unmarried children under age 21, who meet income
and asset requirements for the household size.
B. Maryland Children’s Health Program provides coverage for pregnant women of
any age and children up to age 19 who meet income requirements for their
household size and who are not eligible for any other MA coverage category.
C. Aged, Blind, or Disabled (ABD) provides coverage for people who are 65 or over,
or blind, disabled, or fatally ill and meet income and asset requirements.
D. Qualified Medicare Beneficiaries (QMB) pays specific medical costs for people
who receive Medicare and meet a higher income level than ABD. QMB covers:
• Hospital deductible (Part A)
• Monthly Part B insurance premium
• Annual Part B deductible
E. Special Low-Income Medicare Beneficiaries (SLMB), for people who have more
income than allowed under QMB but with the same asset limits. SLMB pays:
• Medicare Part B monthly insurance premium (normally deducted from Social
Security checks)
1306.2 TRANSITIONAL MEDICAL ASSISTANCE
A. Medical Assistance (MA) may be provided for up to 12 months without a
separate application, for all members of the customer’s household if:
1. Their TCA case was open in three or more months of the six-month period
preceding the month the customer became ineligible for TCA, and:
2. TCA ineligibility was due solely to increased countable earned income
B. Transitional MA may be provided for 4 months without a separate application, if
closing the TCA case closed because of an increase in:
1. Child Support payments received, or
2. A combination of child support and unearned income
C. After the 12-month or 4-month transitional period, customers must complete a
DEPARTMENT OF HUMAN RESOURCES
FAMILY INVESTMENT ADMINISTRATION TEMPORARY CASH ASSISTANCE
MANUAL
MEDICAL ASSISTANCE 1306
COMAR
07.03.03.07 SUPPORTIVE
SERVICES 1300
REVISED AUGUST 2008
Page 2
Medical Assistance application to determine if they continue to be categorically
and financially eligible.
D. When there are both earnings and child support income, close the TCA case for
earnings to allow for the 12-month extension
1306.3 TERMINATION of TRANSITIONAL MA
A. Terminate the transitional MA at the close of the first month during the extension
period in which a change is reported if the result of the change is:
1. Household members are ineligible under another category, and
2. No TCA eligible children reside in the home
B. Terminate the transitional MA if it is discovered that a household member
fraudulently received TCA benefits at any time during the six months preceding
the transitional period
EXAMPLES
1. Ms. Stevens received TCA benefits for herself and her daughter. In September,
at her recertification, she reported that her salary increased to $150 per week.
Her gross monthly income is calculated and applied as follows:
$150 X 4 = $600
$600 - $240 (40% gross monthly income disregard) = $360
The maximum TCA benefit for a family of two is $300 (for demonstration
purposes only) which her countable gross income exceeds by $60. The TCA
case closes effective October and transitional MA benefits for 12 months (from
October through September) are approved.
2. The following June, Ms. Stevens’ daughter Tracy graduated from high school.
Ms. Stevens reported Tracy left home right after graduation to share an
apartment with her girlfriend.
Note: Every time a TCA case is closed or denied for any reason, determine MA
eligibility. If the parent/caretaker relative is ineligible, a pregnant woman and
the children may be eligible for MCHP, etc.
DEPARTMENT OF HUMAN RESOURCES
FAMILY INVESTMENT ADMINISTRATION TEMPORARY CASH ASSISTANCE
MANUAL
MEDICAL ASSISTANCE 1306
COMAR
07.03.03.07 SUPPORTIVE
SERVICES 1300
REVISED AUGUST 2008
Page 3
The case manager closed the transitional MA effective July, after providing 10
days adverse action, before the 12 - month transitional period ended in
September, because Tracy left the household and Ms. Stevens is not eligible for
any other category of Medical Assistance.
3. Ms. Reno received TCA for herself and two children ($400 for demonstration
purposes). Child Support began to collect $500 per month in child support
payments. The child support exceeds the TCA benefit by $100.
Since the child support exceeded $400, the TCA case is closed following 10 days
adverse action to the customer. The transitional MA was authorized for four
months.
4. Ms. Simons received TCA for herself and three children. She received $300 per
month in VA benefits and $150 in child support, which was assigned to the state
while her TCA case was active. Her monthly TCA was $200 (maximum benefit
for demonstration purposes $500 - $300 (VA) = $200). Mr. Simons increased his
monthly support payments to $275. Total income from child support and VA
benefits increased from $450 to $575 per month, $75 more than the maximum
TCA.
Since the combined child support and VA benefits exceeds the TCA benefit of
$500 the TCA closes after 10 days adverse action. The case manager
authorizes transitional MA for 4 months.
ADDITIONAL INFORMATION
• MA Manual
