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1. Income: To qualify for the Medical Access
Program, a person's total income must be below 200% of the Federal
Poverty Level.
· To qualify for the Medical Access Program,
a person's total income (including spouse's income and that of
working dependant children) must be below 200% of the Federal
Poverty Level. The Federal Poverty Level is an amount that is
established each year by the Federal Department of Human Services,
and defines the line of poverty in a given year for the 48 contiguous
states and the District of Columbia. This formula for the federal
poverty level is based on current gross income and factors in
the number of persons in the household. (For current Poverty Levels,
please see the Federal
Department of Human Services)
· The number of persons in a household should
reflect all dependant persons as well (this may include dependant
children, dependant adults, students claimed as dependants, dependant
stepchildren and grandchildren if they are claimed on taxes that
year). This number does not include aunts, uncles, roommates,
non-legally married partners (unless the incomes of those partners
are joined).
· Any money that comes into the household
is counted included in determining household income. Examples
of income include; earned income (employment and/or self employment),
rental property, interest on investments, alimony payments, child
support, Social Security disability or SSI disability, etc. MCAC
uses gross income numbers and does not subtract expenses or taxes
from the household's income. Self employment income may include
allowable Federal deductions (please view the lower right hand
number of the 1040 form for self employment income including allowable
Federal deductions).
· All applicants are required to file a Medicaid
application as part of the enrollment process. They are also required
to follow through with the FIA process for Medicaid determination.
A two-way release of information will be signed so that MCAC and
FIA can communicate in order to insure these patient responsibilities
are being fulfilled.
· Patients who meet MCAC eligibility requirements
will be given or mailed a temporary MCAC card while the FIA Medicaid
eligibility determination process is being completed. If a patient
is subsequently enrolled in Medicaid, the physician will bill
Medicaid for services delivered from the date of Medicaid eligibility,
and the patient will be disenrolled from the MAP.
· Patients who are determined to be ineligible
for Medicaid by FIA and continue to meet the eligibility requirements
for MCAC will continue to be active in the Medical Access Program,
and their file will be reviewed at six months and 1 year for continued
eligibility.
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