If the child has verified information already on file that would qualify them to meet the general requirements for a MAGI program as outlined in KFMAM 2222, this business process is not needed. It would be appropriate for the CE to reset a new 12 months in this instance.
Examples of when this would occur are:
A new application is being worked for the child and they qualify for MAGI Title 19 based on the verified information on file.
NOTE: This does not apply to a child who qualifies for CHIP. If the child qualifies for CHIP during a 12-month CE period for Medicaid, the business process would apply. The allowable change to CHIP coverage would only occur at review.
SSI to other Medicaid coverage
300 active (LTC, HCBS, PRTF, SI, SIA) to other Medicaid coverage (MAGI and LTC)
300 (LTC, HCBS, PRTF, SI, SIA) to other Medicaid coverage (only one active program block)
If the SSI child was on a different program block, start at step 1. If the SSI child is already on the same program block as the other child/children, start at step 2.
Reapply the child to the MAGI program block.
Please follow the steps in the KEES User Manual page Reapply Person – Medical.
The application date is the date the child is being added to the MAGI program block.
Change RMT to MAGI.
Please follow the steps in the KEES User Manual page Add/Update Requested Medical Type - Medical.
For step 6 in the user manual, please ensure the begin month is the current come-up month in KEES.
Add Customer Options for PLT to ensure the child continues on their CE coverage. End-date the record to the last day of their CE Period.
Please follow the steps in the KEES User Manual page Caretaker Relative Denied CTM, Children need PLN - Customer Options.
Run EDBC.
SSI child not previously on MAGI program block, run EDBC for the application month.
SSI child already on MAGI program block, run EDBC for the KEES current come-up month.
Please follow the steps in the KEES User Manual page Running EDBC.
On the Medical EDBC Summary page, confirm the child is receiving CTM, PLN, or CE PLN coverage.
Review NOA.
Once EDBC is saved and accepted, confirm that the CE Period displays on the Medical Person History page.
If it doesn’t display correctly, create a KEES Help Desk ticket.
Journal the actions taken.
These steps are only to be taken if there is a MAGI program for the household that is active and receiving coverage for other members of the household. If the only program block available is the 300 program block, then follow these steps here.
If the child is not on the MAGI program block, start at Section A. If the child is FSO with a role reason of Gets LTC/SSI, start at Section B.
End-date the LTC Data Details Record.
Please follow the steps in the KEES User Manual page LTC Data.
End-date income for the child that has Social Security income to the last day of the month prior to changing coverage to MAGI.
Please follow the steps in the KEES User Manual page End Dating Existing Income.
Run EDBC for the month the LTC coverage ended. Use the Timely Notice Exception Reason of “LTC Late Change."
Review NOA.
Run EDBC for the month after LTC termination month.
Add child to MAGI program block.
Please follow the steps in the KEES User Manual page Add a Program Person - Medical.
The application date is the date the child is being added to the MAGI program block.
Change RMT to MAGI (if necessary).
Please follow the steps in the KEES User Manual page Add/Update Requested Medical Type - Medical.
For step 6 in the user manual, please ensure the begin month is the current come-up month in KEES.
Add Customer Options for PLT to ensure child does not receive PLT Coverage. End-date the record to the last day of their CE Period.
Please follow the steps in the KEES User Manual page Caretaker Relative Denied CTM, Children need PLN - Customer Options.
Run EDBC on the MAGI program block.
300-child not previously on MAGI program block, run EDBC for the application month.
On the Medical EDBC Summary page, confirm the child is receiving CTM, PLN, or CE PLN coverage.
Review NOA.
Run EDBC on the MAGI program block through the KEES come-up month.
Once EDBC is saved and accepted, confirm that the CE Period displays on the Medical Person History page.
If it doesn’t display correctly, create a KEES Help Desk ticket.
Journal the actions taken.
Change RMT to MAGI on the MAGI program block.
Please follow the steps in the KEES User Manual page Add/Update Requested Medical Type - Medical.
For step 6 in the user manual, please ensure the begin month is the current come-up month in KEES.
End-date the LTC Data Details Record.
Please follow the steps in the KEES User Manual page LTC Data.
End-date income for the child that has Social Security income to the last day of the month prior to changing coverage to MAGI.
Please follow the steps in the KEES User Manual page End Dating Existing Income.
Add Customer Options for PLT to ensure child does not receive PLT Coverage. End-date the record to the last day of their CE Period.
Please follow the steps in the KEES User Manual page Caretaker Relative Denied CTM, Children need PLN - Customer Options.
Run EDBC.
Run EDBC for 300 program block for the month of LTC discharge. Use the Timely Notice Exception Reason of “LTC Late Change."
Review NOA.
Run EDBC on both program blocks for the month after LTC termination.
On the Medical EDBC Summary page, confirm the child is receiving CTM, PLN, or CE PLN coverage.
Ensure that the 300 aid code is discontinued.
If the child is not switching from FSO to MEM, please create a KEES Help Desk ticket.
Run EDBC on the MAGI program block through the KEES come-up month.
Once EDBC is saved and accepted, confirm that the CE Period displays on the Medical Person History page.
If it doesn’t display correctly, create a KEES Help Desk ticket.
Journal the actions taken.
These steps are to be taken if there is only a 300 program block. If there is not an active MAGI program block, follow the steps below.
Change RMT to MAGI.
Please follow the steps in the KEES User Manual page Add/Update Requested Medical Type - Medical.
For step 6 in the user manual, please ensure the begin month is the current come-up month in KEES.
End-date the LTC Data Details Record.
Please follow the steps in the KEES User Manual page LTC Data.
End-date income for the child that has Social Security income to the last day of the month prior to changing coverage to MAGI.
Please follow the steps in the KEES User Manual page End Dating Existing Income.
Add Customer Options for PLT to ensure child does not receive PLT Coverage. End-date the record to the last day of their CE Period.
Please follow the steps in the KEES User Manual page Caretaker Relative Denied CTM, Children need PLN - Customer Options.
Run EDBC.
Run EDBC for 300 program block for the month of LTC discharge. Use the Timely Notice Exception Reason of “LTC Late Change”.
Review NOA.
Run EDBC for the month after LTC discharge. Use the Timely Notice Exception Reason of “LTC Late Change”.
On the Medical EDBC Summary page, confirm the child is receiving CTM, PLN, or CE PLN coverage.
Review NOA.
Run EDBC on the MAGI program block through the KEES come-up month.
Once EDBC is saved and accepted, confirm that the CE Period displays on the Medical Person History page.
If it doesn’t display correctly, create a KEES Help Desk ticket.
Journal the actions taken.
Eligibility worker receives the PPS Continuous Eligibility (CE) Transfer Request Form. This form will be treated as a new application for the child.
To determine the remaining CE for the child, use the Review Month from the Foster Care case medical program block.
Eligibility worker will find a usable case (a) or create a new case if no usable case exists (b).
Please follow the steps in the KEES User Manual page Existing Case Manual Application Registration Medical.
Please follow the steps in the KEES User Manual page New Case Manual Application Registration Medical.
Reapply the child to the MAGI program block.
Please follow the steps in the KEES User Manual page Reapply Person Medical.
The application date is the date the agency received the form.
Add the child back into the home.
Please follow the steps in the KEES User Manual page Household Status Family Medical.
Add Customer Options to ensure the child continues on their Medicaid CE coverage. End-date the record to the last day of their CE Period.
For an existing MAGI program block that is active, add customer option for PLT.
For new or discontinued MAGI program block, add customer option for CTM, PLN, and PLT.
Please follow the steps in the KEES User Manual page Caretaker Relative Denied CTM, Children need PLN - Customer Options.
Navigate to Run EDBC and change the view date to the application month.
Run EDBC.
On the Medical EDBC Summary page, confirm the child is receiving CTM, PLN, or CE PLN coverage.
Review NOA.
Run EDBC through the KEES come-up month.
Once EDBC is saved and accepted, confirm that the CE Period displays on the Medical Person History page.
If it doesn’t display correctly, create a KEES Help Desk ticket.
Journal the actions taken.