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Oklahoma Department of
Human Services
Stronger Families Grow
Brighter Futures
Oklahoma Department of Human Services
Sequoyah Memorial Office Building, 2400 N. Lincoln Blvd. • Oklahoma City, OK 73105
(405) 521-3646 • Fax (405) 521-6684 • Internet: www.okdhs.org
 
 
 
340:10-3-75. Continued medical benefits (CMB)
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Revised 6-1-09

 

(a) Conditions for CMB.  Medical benefits are continued when a Temporary Assistance for Needy Families (TANF) benefit is closed due to the receipt of child or spousal support, or new or increased earnings of the caretaker relative.  • 1  The medical benefits coverage is of the same amount, duration, and scope as if the assistance unit continued receiving TANF.  Eligibility for CMB begins with the effective date of closure or the effective date of closure had the income been reported timely.  A person is included for CMB only if that person was eligible for TANF and included in the assistance unit at the time of the closure.  To be eligible for CMB the assistance unit must meet all of the requirements listed in (1) - (4) of this subsection.

  • (1) At least one member received TANF in at least three of the six months immediately preceding the month of case closure.
  • (2) The assistance cannot have received fraudulently as determined by Family Support Services Division Benefit Integrity and Recovery Section in any one of those six months.
  • (3) The assistance unit must include a dependent child who meets the age and relationship requirements for TANF and whose needs are included in the TANF assistance unit at the time of closure, unless the only eligible child is a Supplemental Security Income (SSI) recipient.
  • (4) Client must comply with Soonercare (Medicaid) citizenship and identity verification rules at OAC 317:35-5-25.

(b) Closure due to child support or spousal support.  Medical benefits are continued if the TANF closure is due to the receipt of new or increased child support or payments for spousal support in the form of alimony.  The medical benefits are continued for four months.

(c) Closure due to new or increased earnings of caretaker relative.  Medical benefits are continued if the closure is due to the new or increased earnings of the caretaker relative.  The caretaker relative's needs must be included in the assistance unit at the time of closure.  The caretaker relative who is the natural or adoptive parent is required to cooperate with Oklahoma Child Support Services (OCSS) during the period of time the family is receiving CMB.  If the caretaker relative changes during the CMB period, the assistance unit loses its CMB coverage.

  • (1) Eligibility.  Medical benefits may be continued for a period up to 12 months.  This period is divided into two six-month periods with eligibility requirements and procedures for each period.
    • (A) Initial six-month period.  The assistance unit is eligible for CMB if:
      • (i) an eligible child remains in the home;
      • (ii) the caretaker relative remains the same; and
      • (iii) the assistance unit remains in Oklahoma.
    • (B) Additional six-month period.  Medical benefits are continued for the additional six month period if:
      • (i) an eligible child remains in the home;
      • (ii) the caretaker relative remains the same;
      • (iii) the assistance unit remains in Oklahoma;
      • (iv) the assistance unit was eligible for and received CMB for each month of the initial six month period;
      • (v) the assistance unit has complied with reporting requirements in (4) of this subsection;
      • (vi) the assistance unit has average monthly earned income that does not exceed the standard which is based on 185% of the Federal Poverty Level; and
      • (vii) the caretaker relative had earnings in each month of the three-month reporting period, unless the lack of earnings was due to an involuntary loss of employment, illness, or other good cause.
    • (C) Income eligibility.  Income eligibility is determined using rules in (i) through (ix) of this subsection.
      • (i) The unearned income and resources of the assistance unit are disregarded in determining eligibility for CMB.
      • (ii) There is no earned income test for the initial six-month period.
      • (iii) The assistance unit's medical benefits are not continued for the additional six-month period if the assistance unit's countable earnings exceed the standard.
      • (iv) Income is determined by averaging the entire assistance unit's gross monthly earnings for the three-month reporting period.
      • (v) Use average family size for the immediate preceding three months when the family size changes during the three-month period.
      • (vi) The only deduction allowed is the cost for approved child care necessary for the employment of the caretaker relative.  The child care deduction is averaged for the same three-month reporting period.  There is no maximum amount for this deduction.
      • (vii) The earnings of all assistance unit members are used in determining the earned income test.  The earnings of additional family members are considered only if that member is a natural or adoptive parent.
      • (viii) The needs of all persons whose earnings are considered are included in determining the household size for the income test.
      • (ix) The earned income of a full time student included in the assistance unit is disregarded the same as in TANF rules.
    • (D) Eligible child.  When the TANF benefit is closed and CMB begins, the assistance unit must include an eligible child whose needs were included in the TANF benefit at the time of closure, unless the only eligible child is a SSI recipient.  After the CMB begins, the assistance unit must continue to include an eligible child.  However, age is the only requirement an eligible child must meet.  This means that the eligible child does not have to meet the deprivation factor once CMB begins.
    • (E) Additional members.  After the CMB begins, family members who move into the home cannot be added to the CMB coverage.  This includes siblings and a natural or adoptive parent(s).  If the additional member is in need of medical services, a new application is completed for that person.  If an assistance unit member included in the CMB leaves the home and then returns, that member may be added back to the CMB coverage if all conditions of eligibility are met.  A child under the age of one year whose mother is included in the CMB coverage, is added to the assistance unit if the child is deprived of parental support.
    • (F) Third party liability.  The assistance unit's eligibility for CMB is not affected by a third party liability.  However, the assistance unit is responsible for reporting all insurance coverage and any changes in the coverage.  The worker must explain the necessity for applying benefits from private insurance to the cost of medical care.  • 2
    • (G) Termination of CMB.  The CMB coverage is discontinued any time the assistance unit fails to meet the eligibility requirements as shown in this Section.  If it becomes necessary to discontinue the CMB coverage for the assistance unit or any member of the assistance unit, the person must be advised that he or she may be eligible for medical benefits under the regular SoonerCare (Medicaid) Program and how to obtain these benefits.  • 3
  • (2) Notification.  Notices are sent to the assistance unit, both at the onset of and throughout the CMB period.  These notices, which are sent at specific times, inform the assistance unit of its rights and responsibilities.  When a TANF benefit is closed and the assistance unit is eligible for CMB, the computer-generated closure notice includes notification of the continuation of medical benefits.  Another computer-generated notice is sent at the same time to advise the assistance unit of the reporting requirements and under what circumstances the medical benefits may be discontinued.  Each notice listed in (A) through (C) of this paragraph includes specific information about what the assistance unit must report.  The notices serve as the required advance notification in the event benefits are discontinued as a result of the information furnished in response to these notices.
    • (A) Notice #1.  PSNCM1 is issued in the third month of the initial continued medical eligibility period.  This notice advises the assistance unit of the additional six-month period of CMB, the eligibility conditions, reporting requirements, and appeal rights.
    • (B) Notice #2.  PSNCM2 is issued in the sixth month of the continued medical eligibility period, but only if the assistance unit is eligible for the additional six-month period.  This notice advises the assistance unit of the eligibility conditions, reporting requirements, and appeal rights.
    • (C) Notice #3.  PSNCM3 is issued in the ninth month of the continued medical eligibility period, or the third month of the additional six-month period.  This notice advises the assistance unit of the eligibility conditions, the reporting requirements, appeal rights, and the expiration of CMB coverage.
  • (3) Notices not received.  In some instances the assistance unit does not receive all of the notices listed in (c)(2)(A)-(C) of this Section.  • 4  The notices and report forms are not issued retroactively.  • 5
  • (4) Reporting.  The assistance unit is required to periodically report specific information.  To assist the unit, Form 08TA018E, Continued Medical Benefit Reply Form, is sent at the same time as the notices generated during the CMB period.  Though preferred, it is not mandatory for the report form itself to be returned.  The information may be reported by telephone, in an office interview, or by letter.  • 6
    • (A) The assistance unit must report:
      • (i) gross earned income of the entire assistance unit for the appropriate three-month period;  • 7
      • (ii) child care expenses, for the appropriate three-month period, necessary for the caretaker relative's continued employment;
      • (iii) changes in members of the assistance unit;
      • (iv) residency; and
      • (v) third party liability.
    • (B) The reporting requirement time frames are explained in this subparagraph.
      • (i) The information requested in the third month must be received by the 21st day of the fourth month and is used to determine the assistance unit's eligibility for the additional six-month period.  While this report is due in the fourth month, negative action cannot be taken during the initial period for failure to report.  If the assistance unit fails to submit the requested information, benefits are automatically suspended effective the seventh month.  If action to reinstate is not taken by deadline of the suspension month, the computer automatically closes the case effective the next month.
      • (ii) The information requested in the sixth month must be furnished by the 21st day of the seventh month.  The decision to continue benefits into the eighth month is determined by the information reported.
      • (iii) The information requested in the ninth month must be furnished by the 21st day of the tenth month.  The decision to continue medical benefits into the 11th month is determined by the information reported.
        • (I) When the information is not reported timely, the CMB are automatically suspended by the computer for the appropriate effective date.
        • (II) If the assistance unit subsequently reports the necessary information, the worker determines eligibility.
        • (III) If all eligibility factors are met during and after the suspension period, the medical benefits are reinstated.  The effective date of the reinstatement is the same as the effective date of the suspension so the assistance unit has continuous medical coverage.

(d) Receipt of medical benefits after CMB ends.  To ensure continued medical coverage, Form 08MA007E, Recertification of Eligibility for SoonerCare Health Benefits, is computer-generated and mailed to the assistance unit during the third month of CMB for benefits closed due to the receipt of child or spousal support or the 11th month of CMB for benefits closed due to increased earnings.  The assistance unit must return Form 08MA007E for a medical redetermination to be made prior to the termination of the CMB benefits.  When determined eligible, medical benefits continue as regular SoonerCare (Medicaid) benefits, not CMB.  • 8  If the assistance unit fails to return Form 08MA007E, medical benefits are terminated. 

INSTRUCTIONS TO STAFF 340:10-3-75

 

Revised 6-1-08

 

1.   When medical benefits are not continued at the Temporary Assistance for Needy Families (TANF) closure and should have been, the worker is responsible for updating the Family Assistance/Client Services (FACS) system to reflect the information listed in (1) - (3) of this Instruction.

(1) In the Interview notebook in the Financial Assistance tab enter Type Action Taken = C, Reason = correct reason code, and Effective Date = same effective date.

(2) In the Eligibility notebook in the Medical General tab enter Type Action Taken = R, Reason = 18A, and Effective Date = correct date.  In the Financial Assistance tab enter Continued Medical Begin Date = correct date or repeat entry.

(3) For each person included for continued medical benefits (CMB), in the Interview notebook under the Household tab enter Benefit Type = C, Status = E, Date = closure date, Benefit Type = M, Status = A, and Date = most recent certification date.

2.  Information regarding the private medical insurance must be kept current in the case record and the computer system.

3.   This requirement is met by providing the person with an application.  The case record must be documented to show this requirement has been met.

4.   For example, if a TANF benefit was to be closed effective 05-01-00 but failed to get closed until 08-01-00, the effective date of CMB would be 05-01-00.  Notice #1 would have normally been issued in July. Since the benefit was not closed timely, the assistance unit will not receive notice #1.

5.  When a notice or report form is not issued to the assistance unit, the worker is responsible for working with the assistance unit to obtain the information necessary to establish their continued medical eligibility.  The case record must contain documentation as to how continued medical eligibility was established.

6.  (a) The Form 08TA018E, Continued Medical Benefit Reply Form, is computer generated on the 25th of each month and is shown on the notice list and the computer screens CM5A or CM5O for each human services center (HSC).  The CM5A screen lists the most recent 08TA018E reports issued for a HSC while the CM5O screen shows only those 08TA018E reports issued after the first three months of CMB and information has not been received and updated by the HSC in the fourth or fifth months of the initial six months of eligibility.  To access these screens enter CM5A or CM5O space HSC number.  When the assistance unit responds to Form 08TA018E, it is the responsibility of the worker to update the CM5A or CM5O screen.  If the information provided indicates continued eligibility, an "X" is entered in the indicator field and the date the form was returned or information received is entered in the date returned field.

(b) CMB benefits are suspended if the CM5A or CM5O screen has not been updated.  A notice of suspension is computer generated to the assistance unit. If it is determine that the assistance unit continues eligible for CMB benefits after the suspension action has taken place, the worker must reinstate the benefits effective the same effective date as the suspension.  If a determination is made that the assistance unit will be ineligible at the beginning of the seventh month, the appropriate action is taken on the FACS system on the Medical General tab.

7.   Gross earned income must be verified and documented.

8.  When the assistance unit returns the Form 08MA007E, Recertification of Eligibility for SoonerCare Health Benefits, and continued medical benefits are appropriate, the worker must update the Certification Period in the Medical General tab of FACS.  The FACS system updates the entries for the Continued Medical Begin Date, Continued Medical Expiration Date, and shows the TANF benefits removed.

 



Last Updated:  10/17/2011
Oklahoma Department of Human Services
Street address: Sequoyah Memorial Office Building, 2400 N. Lincoln Blvd., Oklahoma City, OK 73105
Mailing address: P.O. Box 25352, Oklahoma City, OK 73125
(405) 521-3646
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