Appendix F Categories Affected by FMAP Initiative

Category

FMAP

TT

Eligibility Rules

PH00 Regular A
  • Age 65 and over
  • Income 0-100% FPL
  • No Medicare
M
  • Permanently Disabled
  • MRT or SSA verification
  • Age 0-64
  • Income 0-100% FPL
  • No Medicare
D
  • Permanently disabled or temporarily disabled for 12 months or more
  • No MRT or SSA verification
  • Age 0-64
  • Income 0-100% FPL
  • No Medicare
  • (Over income for MG because of a difference in income calculation)
MG90 Enhanced

N

  • Age 19-20
  • No Medicare
  • Income 0 - Enhanced MNO FPL
  • Permanently disabled and non-disabled
D
  • Age 19-64
  • Permanently disabled
  • MRT or SSA verification
  • No Medicare
  • Income 0-102% FPL
P
  • Women who become pregnant while open in MG90 or MG90D
MG91 Newly Eligible No TT
  • Non-disabled Parents/Caretakers Age 21-64 - 33-133% FPL
  • Non-disabled Childless adults Age 21-64 - 0-133% FPL
  • Permanently Disabled adults Age 21-64 disability verified by MRT/SSA, no Medicare - 102-133% FPL
  • Permanently Disabled adults Age 21-64, disability not verified by MRT/SSA - 0-133% FPL
  • Non-Disabled Age 19-20 - above Enhanced MNO-133% FPL
  • Disabled Age 19-20, disability verified by SSA/MRT - 102-133% FPL
  • Disabled Age 19-20, disability not verified by SSA/MRT - above Enhanced MNO-133% FPL
P
  • Women who become pregnant while open in MG91
PD38/PD39 Regular  
  • State/County Inmate Inpatient
  • Permanent residents under the 5-year bar and temporary aliens
MG38/MG39 Newly Eligible  
  • State/County Inmate Inpatient
  • Citizens, refugees, permanent residents over the 5-year bar

 

 

 

Reviewed Janury 13, 2025, Replacing December 14, 2022