Aid codes are a combination of the medical program, medical program subtype, individual medical subtype and SOBRA/Inmate indicators.
Aid Codes are made up of 7 characters. The first 3 characters are the type of coverage. The next 2 characters further define the category. The last 2 characters are Y/N fields to identify SOBRA and Inmates. SOBRA coverage is identified in the 6th position of the Aid Code. Inmate coverage is identified in the 7th position of the Aid Code.
For example, an aid code of CTM/PW/N/N would indicate Caretaker Medical by looking at the first 3 letters (CTM) of the Aid Code. The second set of letters (PW) indicates Pregnant Woman. SOBRA and Inmate are both “N” in this example.
When the MDN/XX aid code is generated for a Long Term Care case this needs to be changed to a 300/XX aid code. The PMG aid codes do not require adjustment since these are already 300 aid codes. The SSI aid codes do not require adjustment since the aid code is at or below the SSI limit.
300/OA/N/N which translates to 300% of SSI Standard – Aged/Not SOBRA/Not Inmate
300 aid codes are required for LTC. See Medical Aid Codes for more information.
A consumer must have a 300 aid code for MMIS. When the user processes a case for Long Term Care the aid code is 300/XX if the consumer is under the 300% of the SSI limit on income. For 2021, this is $2382.00 in monthly income. If the Consumer's income is more than $2382.00 per month the consumer receives an MDN/XX aid code on the EDBC Summary. This aid code MUST be changed to the 300/XX aid code using the Medical Summary Override for benefits to be sent to the MMIS. Select the appropriate Medically Needy - below SSI Standard or Medically Needy - below SSI Standard Cost Share depending on the consumer's population (Aged, Blind, Child, or Disabled) and liability determination.
|
Category |
Description |
Aid Code |
Review Type |
|
Adoption Support Medical |
Adoption Support Medical |
AMS/CH |
No Review |
|
Aged Out FC |
Aged Out FC |
AGO/IN |
Super Passive |
|
AIDS Drug Assistance Program |
Part A (Title 1) |
ADP/PA |
No Review |
|
Part B (Title 2) |
ADP/PB |
No Review |
|
|
Breast and Cervical Cancer |
Breast and Cervical Cancer |
BCC/IN |
Targeted |
|
Category |
Description |
Aid Code |
Review Type |
|
Caretaker Medical |
Pregnant Women |
CTM/PW |
Passive |
|
Children |
CTM/CH |
Passive |
|
|
Parent or Caretaker |
CTM/PA |
Passive |
|
|
Extended Medical |
Extended Medical |
EXT/FM |
Passive |
|
Foster Care |
Foster Care Medical DCF |
FCM/DC |
No Review |
|
Foster Care Medical JJA |
FCM/JC |
No Review |
|
|
Foster Care Medical Tribal |
FCM/TC |
No Review |
|
|
Medically Needy |
Medically Needy Pregnant Women |
MDN/PW |
Pre-Populated |
|
Medically Needy Child |
MDN/CH |
Pre-Populated |
|
|
300% of SSI Standard - Child (LTC only) |
300/CH |
Passive |
|
|
Medically Needy - Aged |
MDN/OA |
Passive |
|
|
300% of SSI Standard - Aged (LTC only) |
300/OA |
Passive |
|
|
Medically Needy - Blind |
MDN/BL |
Passive |
|
|
300% of SSI Standard - Blind (LTC only) |
300/BL |
Passive |
|
|
Medically Needy Disabled |
MDN/DS |
Passive |
|
|
300% of SSI Standard - Disabled (LTC only) |
300/DS |
Passive |
|
|
Medicare Saving Plan *When the previous application was an LIS application, the next review will be Pre-Populated. |
Qualified Medicare Beneficiary |
MSP/QB |
Super Passive* |
|
Low Income Medicare Beneficiary |
MSP/LM |
Super Passive* |
|
|
Expanded Low Income Medicare Beneficiary |
MSP/EL |
Super Passive* |
|
|
Qualified Working Disabled |
MSP/QW |
Super Passive* |
|
|
MediKan |
MediKan |
MKN/AD |
Pre-Populated |
|
MediKan - Reintegration |
MKN/RI |
No Review |
|
|
Poverty Level 19 (Title 19) |
Pregnant Women |
PLN/PW |
Super Passive |
|
Deemed Newborn |
PLN/DN |
Super Passive |
|
|
Newborn |
PLN/NB |
Passive |
|
|
Child Age 1 - 5 |
PLN/C2 |
Passive |
|
|
Child Age 6 - 18 FPL <113% |
PLN/C3 |
Passive |
|
|
Child Age 6 - 18 FPL > 113 - 133% No Other Health Ins. |
PLN/C4 |
Passive |
|
|
Child Age 6 - 18 FPL > 113 - 133% With Other Health Ins. |
PLN/C5 |
Passive |
|
|
Poverty Level 21 (CHIP) |
Pregnant Child |
PLT/PW |
Passive |
|
Deemed Newborn |
PLT/DN |
Passive |
|
|
Newborn |
PLT/NB |
Passive |
|
|
Child Age 1 - 5 FPL 150-166% |
PLT/C1 |
Passive |
|
|
Child Age 6 - 18 FPL 134 - 166% |
PLT/C2 |
Passive |
|
|
Newborn FPL > 171% |
PLT/C3 |
Passive |
|
|
Child Age 1 - 5 FPL > 167% |
PLT/C4 |
Passive |
|
|
Child Age 6 - 18 FPL > 167% |
PLT/C5 |
Passive |
|
|
Presumptive Eligibility |
Poverty Level 19 Child |
PEN/CH |
No Review |
|
Pregnant Woman |
PEN/PW |
No Review |
|
|
Poverty Level 21 Child |
PET/CH |
No Review |
|
|
Caretaker Medical |
PEN/CT |
No Review |
|
|
Aged Out FC |
PEN/AO |
No Review |
|
|
Breast and Cervical Cancer |
PEN/BC |
No Review |
|
|
Protected Medical Groups |
Pickle Amendment - Aged |
PMG/PA |
Passive |
|
Pickle Amendment - Blind |
PMG/PB |
Passive |
|
|
Pickle Amendment - Disabled |
PMG/PD |
Passive |
|
|
Adult Disabled Child - Aged |
PMG/AA |
Passive |
|
|
Adult Disabled Child - Blind |
PMG/AB |
Passive |
|
|
Adult Disabled Child - Disabled |
PMG/AD |
Passive |
|
|
Qualifying Disabled Widow/Widowers - Aged |
PMG/QA |
Passive |
|
|
Qualifying Disabled Widow/Widowers - Blind |
PMG/QB |
Passive |
|
|
Qualifying Disabled Widow/Widowers - Disabled |
PMG/QD |
Passive |
|
|
Early Widow/Widower - Blind |
PMG/EB |
Passive |
|
|
Early Widow/Widower - Disabled |
PMG/ED |
Passive |
|
|
SSI Recipients |
SSI Recipients - Aged |
SSI/OA |
No Review |
|
SSI Recipients - Blind |
SSI/BL |
No Review |
|
|
1619 B Blind |
SSI/SB |
No Review |
|
|
SSI Recipients Disabled |
SSI/DS |
No Review |
|
|
1619 B Disabled |
SSI/SD |
No Review |
|
|
Transitional Medical |
Transitional Medical |
TMD/FM |
Passive |
|
Tuberculosis |
Tuberculosis |
TBL/IN |
Internal |
|
Working Healthy |
Working Healthy - Blind |
WKH/RB |
Pre-Populated |
|
Working Healthy - Disabled |
WKH/RD |
Pre-Populated |
|
|
Working Healthy Medically Improved - Blind |
WKH/IB |
Pre-Populated |
|
|
Working Healthy - Improved - Disabled |
WKH/ID |
Pre-Populated |