AFDC-related
"Eligible Beneficiary means any Medi-Cal beneficiary who is residing in the Contractor's service area with an appropriate aid code as identified by the Department and who is not certified as eligible for the Genetically Handicapped Persons Program or the California Children's Services Case Management Program, who is not in need of services for chronic renal dialysis or major organ transplants, or who is not institutionalized in a skilled nursing or intermediate care facility." California Contract, page 5.
"702. Eligible
Aid Categories
1. Membership in
GBHC is mandatory for Medicaid recipients who reside in a GBHC participating
county and who are eligible for Medicaid in one of the following aid categories:
...
b. AFDC-Related
(including SOBRA children and children up to 19 years of age based on the specified
percentage of the federal poverty level)..." Georgia Agreement, page VII-1.
"4.11 Eligible
Clients
Medicaid clients who
must participate in HealthMACS are those for whom the Mississippi Department
of Human Services (DHS) determines eligibility and who live in a county in which
HealthMACS has been implemented. Eligibility categories include:
2. Medical
Assistance (MA): Children under 18 and pregnant women.
3. Expanded
Medicaid (EM): Children under 6 years of age and pregnant women.
4. Infant
Survival (IS): Children up to age 1 and pregnant women.
5. Poverty
Level (PL): Children born after September 30, 1983 and pregnant women."
Mississippi Manual, pages 71, 82-83.
"ARTICLE III...
3.2. Mandatory
and Excluded Clients
3.2.1 Mandatory for the
NHC Basic Benefits Package: The following Medicaid eligible clients are
required to participate in the NHC, if the client's eligibility assistance case
is managed by the Health and Human Services (HHS) District Office in the designated
coverage areas, unless excluded pursuant to 9.2.5 of this contract:
(a) Clients
participating in the Aid to Dependent Children Program Grant/Medical (Title
468 NAC). For purposes of the NHC, this includes clients participating
in the Medical Assistance Programs for Children (i.e., Ribicoff), Medical Assistance
for Children (MAC), School Age Medical (SAM) and Kids Connection pursuant to
Title 469 NAC." Nebraska Contract, page 22.
"5. PERSONS
ELIGIBLE FOR ENROLLMENT
5.1(a) Except as
specified in Section 5.1(b), and 6.1 below: all persons in the following Medicaid
eligible categories, who reside in the Service Area are entitled to voluntary
enrollment in a managed care plan and shall be offered the opportunity for enrollment
with the (PCP/Contractor): ...
"Eligible Recipient - Persons eligible in the following Medicaid categories: ...AFDC-related (MAF)... Recipients who are determined eligible in accordance with Federal and State laws and who reside in a Carolina ACCESS service area." North Carolina Agreement, page 1.