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    Dfcs - Abd Medicaid 5.12

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    j miller
    1) ABD Medicaid in Georgia serves persons who are 65 or older, blind, or totally disabled. There are 19 coverage categories that determine eligibility based on factors like income, assets, living situation, and prior Medicaid eligibility. 2) To apply for ABD Medicaid, individuals must meet non-financial criteria like citizenship, residency in Georgia, and assigning health insurance benefits to the state. They must also meet the financial criteria for income and asset limits that vary based on coverage category. 3) Coverage includes institutional care, community services, Medicare premium assistance, and programs that allow spending down excess income on medical costs to qualify. Eligibility is renewed annually by renewal letter.

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    Dfcs - Abd Medicaid 5.12

    Uploaded by

    j miller
    61 views3 pages
    1) ABD Medicaid in Georgia serves persons who are 65 or older, blind, or totally disabled. There are 19 coverage categories that determine eligibility based on factors like income, assets, living situation, and prior Medicaid eligibility. 2) To apply for ABD Medicaid, individuals must meet non-financial criteria like citizenship, residency in Georgia, and assigning health insurance benefits to the state. They must also meet the financial criteria for income and asset limits that vary based on coverage category. 3) Coverage includes institutional care, community services, Medicare premium assistance, and programs that allow spending down excess income on medical costs to qualify. Eligibility is renewed annually by renewal letter.

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    Dfcs.abd Medicaid 5.12

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    Dfcs.abd Medicaid 5.12

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    1) ABD Medicaid in Georgia serves persons who are 65 or older, blind, or totally disabled. There are 19 coverage categories that determine eligibility based on factors like income, assets, living situation, and prior Medicaid eligibility. 2) To apply for ABD Medicaid, individuals must meet non-financial criteria like citizenship, residency in Georgia, and assigning health insurance benefits to the state. They must also meet the financial criteria for income and asset limits that vary based on coverage category. 3) Coverage includes institutional care, community services, Medicare premium assistance, and programs that allow spending down excess income on medical costs to qualify. Eligibility is renewed annually by renewal letter.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    61 views3 pages

    Dfcs - Abd Medicaid 5.12

    Uploaded by

    j miller
    1) ABD Medicaid in Georgia serves persons who are 65 or older, blind, or totally disabled. There are 19 coverage categories that determine eligibility based on factors like income, assets, living situation, and prior Medicaid eligibility. 2) To apply for ABD Medicaid, individuals must meet non-financial criteria like citizenship, residency in Georgia, and assigning health insurance benefits to the state. They must also meet the financial criteria for income and asset limits that vary based on coverage category. 3) Coverage includes institutional care, community services, Medicare premium assistance, and programs that allow spending down excess income on medical costs to qualify. Eligibility is renewed annually by renewal letter.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    The document discusses the Aged, Blind and Disabled (ABD) Medicaid program in Georgia which provides coverage to those who are 65 or older, blind, or disabled. It outlines the eligibility criteria including income and asset limits and describes different classes of assistance (coverage categories) under the program.

    To be eligible for ABD Medicaid in Georgia, individuals must be 65 or older, blind, or disabled. They must also be a US citizen or lawful permanent resident, a Georgia resident, and meet both non-financial (such as assigning health insurance benefits) and financial criteria including income and asset limits that vary by coverage category.

    The ABD program covers institutional care like nursing homes, hospice and long hospital stays (30+ days). It also covers community care services, mental retardation waivers, and community habilitation support services.

    AGED, BLIND AND DISABLED MEDICAID (ABD)

    AGED, BLIND AND DISABLED MEDICAID IN GEORGIA:


    ABD Medicaid in Georgia serves persons who are 65 years of age or older, legally blind and/or
    totally disabled. There are 19 different coverage categories, known as classes of assistance
    (COA), for the ABD population (see below for the primary categories).
    KEITH HORTON
    COMMISSIONER An individual’s living arrangement, types and amount of income, marital status and prior
    Medicaid eligibility, among other factors, determine the most appropriate COA.

    HOW DOES A FAMILY APPLY FOR ABD?


    Paper applications can be filed at any local DFCS office by mail, fax or in person. If you have
    DFCS LEADERSHIP: difficulty completing the application, someone will assist you at the local office.
    Dr. Sharon Hill WHO CAN RECEIVE ABD?
    Division Director Individuals must meet the following non-financial criteria in addition to meeting the financial
    eligibility criteria before being eligible for any ABD class of assistance:
    Carol Christopher
    Deputy Director Age 65 or older, totally disabled, or blind;
    A U.S. citizen or an alien who was lawfully admitted for permanent residence prior to
    August 22, 1996;
    A resident of Georgia (there is no time limit to establish residency, only the intention to
    permanently live in Georgia);
    Agree to assign all health insurance benefits to the Georgia Department of
    Community Health;
    Apply for and accept all other monetary benefits, payments or allotments.

    Financial Criteria:
    Financial criteria are divided into two groups, income and assets. In determining eligibility, a
    DFCS case manager will consider the total gross monthly income of the applicant from all
    sources. This includes Social Security benefits, any pensions, retirement, wages, interest,
    dividends, etc. If the applicant is living with a spouse, the case manager will also consider the
    income of the spouse.

    Every Medicaid category has a maximum allowable limit for assets. Countable assets do not
    include the individual’s homeplace. One vehicle may be exempt per ABD household.
    Countable assets include but are not limited to:
    Any real property other than the home
    All bank accounts
    Investments such as certificates of deposit, stocks, bonds, and promissory notes
    Inherited property, and jointly owned assets
    Life insurance over $5,000 may count

    An asset counts against the Medicaid limit if the individual has legal ownership and the legal
    right to sell the asset, even if the person does not have physical access to it, or if there is no
    market for it. Any asset given away within the past 60 months may count and result in a
    transfer penalty being applied.
    In addition to the allowable asset limit, an individual is allowed to set aside up to $1,500 or
    $10,000 to pay for funeral expenses, depending on the class of assistance. This money must
    be separately identifiable and cannot be used for any other purpose. Cemetery lots are not
    counted and an individual may own a pre-need burial contract, but depending on the type of
    contract, a portion of the contract may be counted toward the burial limit.

    Individuals with total gross monthly income less than the federal benefit rate who wish to apply
    for Medicaid will be referred to the Social Security Administration to apply for Supplemental
    Security Income (SSI). This is a financial assistance program. If an individual is eligible for SSI,
    he or she qualifies for Medicaid automatically. For 2012, the monthly income maximum is $698
    for an individual and $1,048 for a couple.

    WHAT IS COVERED BY THE ABD PROGRAM?


    Institutionalized Care — Includes nursing home, hospice, and hospital stays of 30 days or
    more; Community Care Services; the Mental Retardation Waiver program; and Community
    Habilitation Support Services.

    The monthly income limit for an individual is $2,094. Individuals whose income is more than
    $2,094 and have a funded Qualified Income Trust established can still be potentially eligible.

    Qualified Medicare Beneficiaries (QMB) — Coverage pays an individual’s Medicare


    premium, Medicare coinsurance and deductibles. Prescription drugs are not covered under this
    COA.

    The income limit for QMB is $931 for an individual and $1,261 for a couple.

    Specified Low-Income Medicare Beneficiaries (SLMB) — Program pays the monthly


    premium for Medicare Supplemental Medical Insurance (Part B). This COA offers no Medicaid
    benefits.

    The income limit for SLMB is $1,117 for an individual and $1,513 for a couple.

    Public Laws — Through the years Congress has passed six public laws that provide
    continued Medicaid coverage for people who have been terminated from Social Security
    Income (SSI). Each public law has different financial criteria.

    Adult Medically Needy — Program has no income limit. Individuals are allowed to use
    medical expenses to “spend down” the difference between their income and the medically
    needy income level.

    The medically needy income level is $317 for an individual and $375 for a couple. Medically
    Needy is calculated on a monthly basis, and only pays for medical bills incurred after the
    spend-down is met each month.

    Deeming Waiver — Available to children under the age of 18 who are financially ineligible for
    SSI and determined to be in need of institutionalized care but have chosen to remain at home
    because they can be cared for at a lower cost.
    The individual income limit is $2,094 gross total income per month. The income and assets of
    the parent(s) are not considered.

    HOW LONG CAN A FAMILY RECEIVE ABD?


    There is no time limit for receiving ABD benefits; however, cases must be renewed each year
    for continued Medicaid eligibility.

    HOW DO I RENEW MY BENEFITS?


    A renewal letter will be mailed to each family or recipient that gives instructions on the renewal
    process. Families can renew their benefits at www.compass.ga.gov. In order to use the online
    renewal process, the family must know the client id of the head of the household and use it to
    create an online account prior to going to the ‘renew my benefits’ section.

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