Effective 03/19/2018
|
Category |
Program Code |
TT |
Description |
|
MG |
17 |
F |
Hospital Based Presumptive Eligibility |
|
MG |
17 |
I |
Hospital Based Presumptive Eligibility |
|
MG |
17 |
C |
Hospital Based Presumptive Eligibility |
|
MG |
17 |
Y |
Hospital Based Presumptive Eligibility |
|
MG |
17 |
T |
Hospital Based Presumptive Eligibility |
|
MG |
17 |
A |
Hospital Based Presumptive Eligibility |
|
PS |
17 |
SMA Presumptive Eligibility |
|
|
PC |
31 |
TANF Federal Foster Care |
|
|
PC |
32 |
TANF Fed Adoption Assistance |
|
|
PC |
33 |
TANF State Foster Care |
|
|
PC |
34 |
TANF State Adoption Assistance |
|
|
PC |
35 |
Adoption ASST-FSTR Care Other State |
|
|
PC |
36 |
Fed Adoption Assistance Other State |
|
|
PC |
37 |
Subsidized Perm Legal Custodian |
|
|
PCN |
31 |
Federal Foster Care Long Term Care |
|
|
PCN |
32 |
Federal Adoption Asst Long Term Care |
|
|
PCN |
33 |
State Foster Care Long Term Care |
|
|
PCN |
34 |
State Adoption Asst Long Term Care |
|
|
PCN |
35 |
Out of State Foster Care Long Term Care |
|
|
PCN |
36 |
Out of State Adopt Asst Long Term Care |
|
|
PCN |
37 |
Subsidized SPLC Long Term Care |
|
|
PAN |
80 |
Aged Long Term Care w/Buy-In (NMP) |
|
|
PMN |
80 |
Blind Long Term Care w/Buy-In (NMP) |
|
|
PJN |
80 |
Disabled Long Term Care w/Buy-In (NMP) |
|
|
PVN |
80 |
VA Long Term Care w/Buy-In (NMP) |
|
|
PAN |
66 |
Aged Long Term Care w/Buy-In (NMP) |
|
|
PMN |
66 |
Blind Long Term Care w/Buy-In (NMP) |
|
PJN |
66 |
Disabled Long Term Care w/Buy-In (NMP) |
|
|
PVN |
66 |
VA Long Term Care w/Buy-In (NMP) |
|
|
PAN |
00 |
Aged Long Term Care (NMP) |
|
|
PMN |
00 |
Blind Long Term Care (NMP) |
|
|
PJN |
00 |
Disabled Long Term Care (NMP) |
|
|
PVN |
00 |
VA Long Term Care (NMP) |
|
|
TAN |
80 |
Aged Long Term Care w/Buy-In (MNO) |
|
|
TJN |
80 |
Disabled Long Term Care w/Buy-In (MNO) |
|
|
TVN |
80 |
VA Long Term Care w/Buy-In (MNO) |
|
|
TAN |
66 |
Aged Long Term Care w/Buy-In (MNO) |
|
|
TJN |
66 |
Disabled Long Term Care w/Buy-In (MNO) |
|
|
TVN |
66 |
VA Long Term Care w/Buy-In (MNO) |
|
|
TAN |
00 |
Aged Long Term Care (MNO) |
|
|
TJN |
00 |
Disabled Long Term Care (MNO) |
|
|
TVN |
00 |
VA Long Term Care (MNO) |
|
|
PCN |
02 |
Refugee Long Term Care |
|
|
PAW |
81 |
Aged Special SSI Waiver - DAC |
|
|
PMW |
81 |
Blind Special SSI Waiver - DAC |
|
|
PJW |
81 |
Disabled Special SSI Waiver - DAC |
|
|
PJW |
83 |
Disabled Special SSI Waiver - Widow(er) |
|
|
PAW |
84 |
Aged Special SSI Waiver - Pickle |
|
|
PMW |
84 |
Blind Special SSI Waiver - Pickle |
|
|
PJW |
84 |
Disabled Special SSI Waiver - Pickle |
|
|
PAW |
85 |
Aged Special SSI Waiver - Disab Emp |
|
|
PMW |
85 |
Blind Special SSI Waiver - Disab Emp |
|
|
PJW |
85 |
Disabled Special SSI Waiver - Disab Emp |
|
|
PAW |
80 |
Aged Waiver Program w/Buy-In (NMP) |
|
|
PMW |
80 |
Blind Waiver Program w/Buy-In (NMP) |
|
PJW |
80 |
Disabled Waiver Program w/Buy-In (NMP) |
|
|
PAW |
66 |
Aged Waiver Program w/Buy-In (NMP) |
|
|
PMW |
66 |
Blind Waiver Program w/Buy-In (NMP) |
|
|
PJW |
66 |
Disabled Waiver Program w/Buy-In (NMP) |
|
|
PAW |
00 |
Aged Waiver Program (NMP) |
|
|
PMW |
00 |
Blind Waiver Program (NMP) |
|
|
PJW |
00 |
Disabled Waiver Program (NMP) |
|
|
TAW |
80 |
Aged Waiver Program w/Buy-In (MNO) |
|
|
TJW |
80 |
Disabled Waiver Program w/Buy-In (MNO) |
|
|
TAW |
66 |
Aged Waiver Program w/Buy-In (MNO) |
|
|
TJW |
66 |
Disabled Waiver Program w/Buy-In (MNO) |
|
|
TAW |
00 |
Aged Waiver Program (MNO) |
|
|
TJW |
00 |
Disabled Waiver Program (MNO) |
|
|
PCW |
02 |
Refugee Waiver Program |
|
|
PA |
81 |
Aged Disabled Adult Child |
|
|
PM |
81 |
Blind Disabled Adult Child |
|
|
PJ |
81 |
Disabled Adult Child |
|
|
PJ |
83 |
Disabled Widow(er) |
|
|
PA |
84 |
Aged Indv - Pickle |
|
|
PM |
84 |
Blind Indv - Pickle |
|
|
PJ |
84 |
Disabled Indv - Pickle |
|
|
PA |
85 |
Aged Disable Employed Indv |
|
|
PM |
85 |
Blind Disable Employed Indv |
|
|
PJ |
85 |
Disabled Employed Indv |
|
|
PA |
86 |
Aged QDWI Indv |
|
|
PM |
86 |
Blind QDWI Indv |
|
|
PJ |
86 |
Disabled QDWI Indv |
|
|
PC |
03 |
Refugee Unaccompanied Minor |
|
PH |
80 |
A |
Cat. Needy Healthy Horiz w/Buy-In |
|
PH |
80 |
D |
Cat. Needy Healthy Horiz w/Buy-In |
|
PH |
00 |
M |
Healthy Horizons – Disability Verified by SSA or MRT |
|
MG |
27 |
I |
MAGI Infant (Below TANF NMP Limit) |
|
MG |
27 |
C |
MAGI Child (Below TANF NMP Limit) |
|
MG |
27 |
Y |
MAGI Youth (Below TANF NMP Limit) |
|
MG |
27 |
T |
MAGI Caretaker (Below TANF NMP Limit) |
|
MG |
71 |
I |
TMA MAGI Infant (Earned Income) |
|
MG |
71 |
C |
TMA MAGI Child (Earned Income) |
|
MG |
71 |
Y |
TMA MAGI Youth (Earned Income) |
|
MG |
71 |
T |
TMA MAGI Caretaker (Earned Income) |
|
MG |
23 |
I |
TMA MAGI Infant (Alimony) |
|
MG |
23 |
C |
TMA MAGI Child (Alimony) |
|
MG |
23 |
Y |
TMA MAGI Youth (Alimony) |
|
MG |
23 |
T |
TMA MAGI Caretaker (Alimony) |
|
MG |
19 |
Y |
MAGI Youth (Newly Eligible) |
|
MG |
00 |
P |
MAGI Pregnant Woman |
|
MG |
00 |
I |
MAGI Infant |
|
MG |
00 |
C |
MAGI Child |
|
MG |
00 |
Y |
MAGI Youth |
|
PC |
40 |
Former Foster Care |
|
|
MG |
90 |
N |
Enhanced FMAP - Age 19 to 20 |
|
MG |
90 |
D |
Enhanced FMAP - Permanently Disabled |
|
MG |
90 |
P |
Enhanced FMAP- Pregnancy Reported |
|
MG |
91 |
P |
Newly eligible - Pregnancy Reported |
|
MG |
91 |
Newly Eligible |
|
|
PH |
00 |
A |
Aged Healthy Horizons |
|
PH |
00 |
D |
Disabled Healthy Horizons |
|
PA |
00 |
Aged NMP |
|
|
PM |
00 |
Blind NMP |
|
|
PJ |
00 |
Disabled NMP |
|
|
PA |
22 |
Aged Ongoing Spend-Down (NMP) |
|
|
PM |
22 |
Blind Ongoing Spend-Down (NMP) |
|
|
PJ |
22 |
Disabled Ongoing Spend-Down (NMP) |
|
|
PA |
21 |
Aged Monthly Spend-Down (NMP) |
|
|
PM |
21 |
Blind Monthly Spend-Down (NMP) |
|
|
PJ |
21 |
Disabled Monthly Spend-Down (NMP) |
|
|
PC |
02 |
A |
Refugee Medical Assistance |
|
PD |
00 |
F |
GA Perm Res Subject to 5 Year Bar and Temp Aliens (NMP) |
|
PD |
00 |
D |
GA Perm Res Subject to 5 Year Bar and Temp Aliens (NMP) |
|
PD |
00 |
H |
GA Perm Res Subject to 5 Year Bar and Temp Aliens (NMP) |
|
PD |
00 |
A |
GA Perm Res Subject to 5 Year Bar and Temp Aliens (NMP) |
|
PD |
00 |
V |
GA Perm Res Subject to 5 Year Bar and Temp Aliens (NMP) |
|
PD |
22 |
F |
GA Chron Need Spend-Down (Ongo) Perm Res Subject to 5 Year Bar and Temp Aliens (NMP) |
|
PD |
22 |
D |
GA Chron Need Spend-Down (Ongo) Perm Res Subject to 5 Year Bar and Temp Aliens (NMP) |
|
PD |
22 |
H |
GA Chron Need Spend-Down (Ongo) Perm Res Subject to 5 Year Bar and Temp Aliens (NMP) |
|
PD |
22 |
A |
GA Chron Need Spend-Down (Ongo) Perm Res Subject to 5 Year Bar and Temp Aliens (NMP) |
|
PD |
22 |
V |
GA Chron Need Spend-Down (Ongo) Perm Res Subject to 5 Year Bar and Temp Aliens (NMP) |
|
PD |
21 |
F |
GA Chron Need Spend-Down (Monthly) Perm Res Subject to 5 Year Bar and Temp Aliens (NMP) |
|
PD |
21 |
D |
GA Chron Need Spend-Down (Monthly) Perm Res Subject to 5 Year Bar and Temp Aliens (NMP) |
|
PD |
21 |
H |
GA Chron Need Spend-Down (Monthly) Perm Res Subject to 5 Year Bar and Temp Aliens (NMP) |
|
PD |
21 |
A |
GA Chron Need Spend-Down (Monthly) Perm Res Subject to 5 Year Bar and Temp Aliens (NMP) |
|
PD |
21 |
V |
GA Chron Need Spend-Down (Monthly) Perm Res Subject to 5 Year Bar and Temp Aliens (NMP) |
|
PH |
20 |
Breast & Cervical Cancer |
|
|
MG |
18 |
P |
MAGI Income Ineligible Pregnant Women |
|
PW |
80 |
MAWD w/Buy-In |
|
|
PW |
66 |
MAWD w/Buy-In |
|
|
PW |
00 |
MAWD |
|
|
PI |
80 |
Med Improved MAWD w/Buy-In |
|
|
PI |
66 |
Med Improved MAWD w/Buy-In |
|
|
PI |
00 |
Medically Improved MAWD |
|
|
PAW |
80 |
A |
Aged Waiver Program w/Buy-In (NMP) |
|
PAW |
66 |
A |
Aged Waiver Program w/Buy-In (NMP) |
|
PAW |
00 |
A |
Aged Waiver Program (NMP) |
|
PMW |
80 |
A |
Blind Waiver Program w/Buy-In (NMP) |
|
PMW |
66 |
A |
Blind Waiver Program w/Buy-In (NMP) |
|
PMW |
00 |
A |
Blind Waiver Program (NMP) |
|
PJW |
80 |
A |
Disabled Waiver Program w/Buy-In (NMP) |
|
PJW |
66 |
A |
Disabled Waiver Program w/Buy-In (NMP) |
|
PJW |
00 |
A |
Disabled Waiver Program (NMP) |
|
PCW |
02 |
A |
Refugee Waiver Program |
|
TA |
80 |
Aged MNO w/Buy-In |
|
|
TJ |
80 |
Disabled MNO w/Buy-In |
|
|
TA |
66 |
Aged MNO w/Buy-In |
|
|
TJ |
66 |
Disabled MNO w/Buy-In |
|
|
TA |
00 |
Aged MNO |
|
|
TJ |
00 |
Disabled MNO |
|
|
TU |
00 |
T |
Unemployment TANF MNO |
|
TU |
00 |
P |
Unemployment TANF MNO Pregnant |
|
TC |
00 |
T |
Absent Parent TANF MNO |
|
TC |
00 |
N |
Absent Parent TANF MNO Under 21 |
|
TC |
00 |
P |
Absent Parent TANF MNO Pregnant |
|
PD |
00 |
C |
GA Perm Res Subject to 5 Year Bar and Temp Aliens (NMP) |
|
PD |
22 |
C |
GA Chron Need Spend-Down (Ongo) Perm Res Subject to 5 Year Bar and Temp Aliens (NMP) |
|
PD |
21 |
C |
GA Chron Need Spend-Down (Monthly) Perm Res Subject to 5 Year Bar and Temp Aliens (NMP) |
|
TD |
00 |
C |
GA Chronically Needy Perm Res Subject to 5 Year Bar and Temp Aliens (MNO) |
|
TD |
00 |
A |
GA Chronically Needy Perm Res Subject to 5 Year Bar and Temp Aliens (MNO) |
|
TD |
00 |
W |
GA Chronically Needy Perm Res Subject to 5 Year Bar and Temp Aliens (MNO) |
|
TA |
22 |
Aged SSI Spend-Down (MNO) |
|
|
TJ |
22 |
Disabled SSI Spend-Down (MNO) |
|
|
TU |
22 |
T |
Unemployment TANF MNO Spend-Down |
|
TU |
22 |
P |
Unemployment TANF MNO Pregnant Spend-Down |
|
TC |
22 |
T |
Absent Parent TANF MNO Spend-Down |
|
TC |
22 |
N |
Absent Parent TANF MNO Under 21 Spend-Down |
|
TC |
22 |
P |
Absent Parent TANF MNO Pregnant Spend-Down |
|
TD |
22 |
C |
GA Spend-Down Perm Res Subject to 5 Year Bar and Temp Aliens (MNO) |
|
TD |
22 |
A |
GA Spend-Down Perm Res Subject to 5 Year Bar and Temp Aliens (MNO) |
|
TD |
22 |
W |
GA Spend-Down Perm Res Subject to 5 Year Bar and Temp Aliens (MNO) |
|
MG |
18 |
N |
MAGI Income Ineligible Newborn |
|
PC |
02 |
C |
Refugee Medical Assistance |
|
PC |
02 |
M |
Refugee Medical Assistance |
|
PSF |
15 |
Family Planning Services |
|
|
PSF |
14 |
Family Planning Services (Good Cause) |
|
|
PH |
95 |
Cat.Needy Child with Special Needs |
|
|
MG |
18 |
C |
Continuous Eligibility for Children Under 4 |
|
PG |
00 |
A |
Aged Healthy Horizons Cost Sharing w/Buy-In |
|
PG |
00 |
D |
Disabled Healthy Horizons Cost Sharing w/Buy-In |
|
TA |
65 |
Aged SLMB w/ Part B Buy-In |
|
|
TJ |
65 |
Disabled SLMB w/ Part B Buy-In |
|
|
TA |
67 |
Aged Qual. Individual (QI-1) Buy-In Only |
|
|
TJ |
67 |
Disabled Qual. Individual (QI-1) Buy-In Only |
|
|
TA |
68 |
Aged Qual. Individual (QI-2) Partial Part B Buy-In Only |
|
|
TJ |
68 |
Disabled Qual. Individual (QI-2) Partial Part B Buy-In Only |
|
|
PC |
30 |
Release from YDC |
|
|
PH |
38 |
SSA Disabled SCI Inmates |
|
|
PH |
39 |
SSA Disabled County Inmates |
|
|
PC |
38 |
TANF SCI Inmates (NMP) |
|
|
PC |
39 |
TANF County Inmates (NMP) |
|
|
PD |
38 |
GA Disabled SCI Inmates – Perm Res Subject to 5-Year Bar and Temp Aliens (NMP) |
|
|
PD |
39 |
GA Disabled County Inmates – Perm Res Subject to 5- Year Bar and Temp Aliens (NMP) |
|
|
MG |
38 |
SCI Inpatient Inmates |
|
|
MG |
39 |
County Inpatient Inmates |
Updated March 23, 2018 Replacing March 22, 2018