Using CIS – Chapter 11 |
Scratchpad |
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1:CAMACU PRE-TANF MEDICAL ASSISTANCE CALCULATION __/__/____ __:__:__:
2: App Operator: _________ [Page __ of __ __ _]:
3: Co Record Cat Day Mo Yr Pers Preg? HH <21? P/O to CAMACA :
4: __ _______ __ __ __/____ __ _ _ _ :
5: :
6: #Ch <1: __ #Ch 1> <6: __ #Ch >6: __ :
7: :
8: Recip # _________ Deemed? _ Deemed Elg St: __ NA Deps: __ Support: ____.__:
9: :
10: Earned: ____.__ Std Ded? _ $30 1/3 _ $30 _ :
11: :
12: Incap/Dep Care: # >2: __ ____.__ # <2: __ ____.__ F/P Time? _ :
13: :
14: Unearned: ____.__ Unearned Ded: ___.__ Support: ____.__ Ver: _ :
15: :
16: PD MA Exps: _____.__ UNPD Non-MA Exps: _____.__ UNPD MA Exps: _____.__ :
17: :
18: Net Inc $ ____.__ {Net Inc $ ____.__} {Net Inc $ ____.__}:
19: Cat Limit $ ____.__ {Cat Limit $ ____.__} {Cat Limit $ ____.__}:
20: Net - $10 $ ____.__ :
21: Needed MA Exp $ ____.__ :
22: :
23: XMIT _ :
24: :
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This screen is used to calculate medical assistance eligibility for PC, PU, and PS (Healthy Beginnings) under the pre-TANF (AFDC) rules. This screen will use the income deductions that were in effect prior to 3/1/1997. |
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The only way to access this screen is through CAMACA and the household is ineligible using the TANF work incentive. |
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There is a pass-off field to return to CAMACA to view the income results. |
A Note: |
All fields are refreshed from the CAMACA screen except the incentive fields, standard deduction field, P/O to CAMACA field, and the income result fields. |
Pre-displays county code.
Pre-displays client record number.
Pre-displays the category for appropriate eligibility determination. This field will help in determining the gross and net income test.
Pre-displays this field from CAMACA.
Pre-displays the first month of eligibility and the year.
Pre-displays the number of persons included in the applicant or recipient group.
Pre-displays a “Y” in this field from CAMACA.
Pre-displays a “Y” in this field if the household contains a person under age 21. Pre-displays an “N” if all household members are age 21 or over.
Pass-off field back to the income results on CAMACA.
Pre-displays the number of household children under age one for Healthy Beginnings.
Pre-displays the number of household children between age one and six for Healthy Beginnings.
Pre-displays the number of household children over age six for Healthy Beginnings.
Pre-displays the recipient number from CAMACA.
Pre-displays from CAMACA.
Pre-displays the eligibility status of the non-eligible person. The number of non-assistance dependents and the amount of support being paid to members outside of the household.
Pre-displays the monthly gross earned income amount or net monthly self-employment amount.
Enter a “Y” in this field if the person qualifies for the $90 deduction.
Enter a “Y” in the appropriate incentive field. If not eligible for an incentive, leave the fields blank.
Pre-displays the number of children and incapacity persons and the actual costs of the dependent care.
Pre-displays the monthly gross amount of unearned income.
Pre-displays the amount of allowable deductions.
Pre-displays the actual monthly amount of voluntary or court ordered support.
Pre-displays the code used to record how the income and resource data was verified.
Pre-displays the amount of medical expenses paid by the client. This field will be used in the calculation of the spend-down and patient-pay amounts, if necessary.
Pre-displays the amount of unpaid medical expenses that will not be covered by Medicaid, remains a legal obligation of the client, will not be covered by a third party, and was not previously used as an MA expense. This field will be used in the calculation of spend-down and patient-pay amounts, if necessary.
Pre-displays the amount of unpaid MA expenses that the client is applying for medical assistance coverage. This field will be used in the calculation of patient-pay amounts, if necessary.
The system will calculate the net income. Results are shown on the last income page. For the Healthy Beginnings program, the system will only display results in the first column if there is an entry in either the Preg and or Ch<1 field. The system will only display an entry in the second field if there is an entry in the Ch 1> <6 field. The third field will display the results when there is an entry in the Ch >6 field.
The system will enter the appropriate limit. Refer to the system reference tables. For the Healthy Beginnings program, the system will display the 185% limit in the first field when there is an entry in Preg and or Ch <1 field. The second field will display the 133% limit when there is an entry in the Ch 1> <6 field. The system will display the 100% limit in the third field when there is an entry in the Ch >6 field.
This field will give the net income after subtracting the $10. This is part of the NMP spend-down process.
This will be a system calculation. This will give the spend-down amount if the client is over income.
Enter the work deduction ($90) and the work incentive ($30 1/3 or $30) the applicant/recipient qualifies to determine medical eligibility using the Pre-TANF rules.
Issued: October 1, 1999
