If an individual who needs LTC facility services is not eligible for or not receiving an SSI payment and is not financially eligible for NMP MA, the CAO must determine eligibility for MNO MA. The CAO must authorize payment for MA LTC facility services in one of the following categories:
TAN or TJN—SSI-related in an LTC facility |
|
TAN 00 |
An individual age 65 or older in an LTC facility who is not enrolled in Buy-In. |
TJN 00 |
An individual under age 65 in an LTC facility who is not enrolled in Buy-In. |
TVN—SSI related in a Veterans' home |
|
TVN 00 |
An individual of any age in a Veterans' home who is not enrolled in Buy-In |
NOTE: If an individual in one of the six veterans' homes administered by the DMVA applies for MA LTC, he may receive LTC benefits in the TVN category through the Enhanced Veterans Reimbursement (EVR) Initiative. The Central Unit (CU) is responsible for determining eligibility for people in one of the six veterans' homes. See Section 405.5, Enhanced Veterans Reimbursement for more information.
The MNO MA HCBS categories of TAW and TJW are not currently applicable. If an individual who needs HCBS is not eligible for or not receiving SSI payment and is not financially eligible for NMP MA LTC, the CAO may determine eligibility in a non-LTC related, spend-down category of MA such as PA 21 or PA 22. See Long Term Care Eligibility Handbook Chapter 468 for more information about authorization of HCBS in a spend-down category of MA.
Updated January 12, 2021, Replacing March 12, 2012