Aged, Blind, Disabled (ABD): Tuberculosis (TB) Cases

317:35-5-4.(4)

317:35-5-47

317:35-7-60(a)(5)

317:35-7-44

 

The TB program is intended to cover treatment for the condition. It does not provide full SoonerCare coverage. If applicant wants full SoonerCare but is not age 65 or older, s/he will need to apply with Social Security to get a disability decision.

What is needed to determine eligibility

  1. Verification from a medical doctor that the applicant was diagnosed with an active TB infection.
  2. Use short term ABD policy for determining countable income and resources.
    Use the standards from Appendix C-1 Schedule XIII.
  3. Meets all other eligibility criteria such as SSN, residence, citizenship, etc.

If the applicant has categorical relationship (considered aged, blind or disabled by Social Security’s criteria) but only meets the income/resource standards for TB coverage, choose one of the following from the Categorical Relationship drop down menu in the Medical-General tab.

TBA
Categorically related disabled with a diagnosis of tuberculosis.
TBB
Categorically related disabled with a diagnosis of tuberculosis.
TBD
Categorically related disabled with a diagnosis of tuberculosis

Example

Frank Roosevelt applied for assistance on 03/20/2020. He has never applied with Social Security. He brought a note from Dr. Ross McIntire saying Frank has had an active TB infection since 12/07/2019. His only income is $550 a week in disability from his employer that is treated as earned income. He has one car, a 2015 Honda CR-V EX. He has a checking account at the First Bank of Indio with a balance of $1256. He rents an apartment. He provided a copy of his Social Security card and birth certificate.

Countable Income

$550 × 4.3 = $2365 − $20 = $2345 − $65 = $2280 ÷ 2 = $1140 which is under the Schedule XIII standard.

Countable Resources
One vehicle exempt
Bank account balance: $1256

Countable resource is below the $2000 resource standard.

He meets all the criteria so he is eligible for TB coverage.

ABD screen showing the "household" tab.

Benefit: Optional TB Coverage.
Status: Added.
Effective: Must match the certification date.

ABD screen showing the "income" tab.

Countable Earned: $2365.
Wage Indicator: Above Federal Minimum Wage.
Non-TANF Work Exp: $1205 [$1140 (countable earned) + $65].
General Income Deduction: $20.

ABD screen showing the "resource" tab.

Does anyone have any liquid resources or assets?

Liquid Resource Type: Checking.
Balance: $1256.
Where Located: First Bank of Indio.
Account Number: 354679.

Does anyone own any vehicles or other non-liquid assets?

Vehicle Type: Truck.
Year/Make/Model: 2015 Honda CR-V.
Est Value: $7895.
Amt Owed: $0.
Monthly Payment: $0.

Resource Type: Savings which include cash, bank accounts, etc.
Countable Amt: $1256.

ABD screen showing the "medical fin." tab.

Type Action Taken: Certified or Online Enrollment.
Reason: Any reason can be used.
Application Date: 03/20/2020.
Certification Date: 12/01/2019.
Certification Period: 12.
Effective Months: 99.
Adv. Notice Req: No.
Date of Last Determination: must match Certification Date.
Categorical Relationship: Disabled (Optional TB Coverage).

ABD screen showing the "medical fin." tab.

Medical Application Reason: Optional TB Coverage Only.
Medical Application Source: CO-County Office.

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