Sale of Home Proceeds and Insurance Payments & Repairs

How are the proceeds from the sale of the home property or an insurance payment for home repairs considered in determining eligibility

Social Security Early Retirement and Categorical Relationship

Impact of Early Retirement on Eligibility

NON-PS2 Instructions (TPL)

This is a list with descriptions of the non-PS2 fields in the FACS TPL Tab.

Long Term Care Partnership Insurance

Oklahoma Long Term Care Partnership (LTCP) Program is a policy purchased after 2008 and will have statement on the face page of the qualification from Oklahoma Insurance Department. The policy must be exhausted before client can become eligible for SoonerCare. Having this policy allows the amount of face value of the policy to be protected […]

Buy-In – How Does the Buy-in Work?

Buy-in is certified (QMB, SLMB, or QI-1) and OKDHS sends Buy-In (accretion) requests to CMS in Baltimore, MD. Client must be on Medicare, or going on the next month, before a Buy-In benefit can be coded on the case. If a worker adds a client to a buy-in benefit when the client is not yet […]

How to Code Third Party Liability (TPL)

Information regarding Third Party Liability (TPL) needs to be coded on the TPL tab in FACS so that the Oklahoma Health Care Authority (OHCA) can make sure the private insurance covers their part before OHCA pays anything on a bill. Make a copy of the insurance card so the information from that card can be […]

What is Insure Oklahoma?

Insure Oklahoma is an innovative program Oklahoma has created to bridge the gap in health care coverage for low-income working adults. Under the Employer-Sponsored Insurance (ESI) program, premium costs are shared by the state (60%), the employer (25%) and the employee (15%). The Individual Plan (IP) allows people who can’t access the benefits through their […]

State Data Exchange (SDX) Resource Codes

Block 025 – House A – Possession of a home – principal place of residence S – Equity in non-excludable property is to increase in value T – Home and Equity in non-excludable property Z – None Blank – not determined Block 026 – Auto B – Vehicle – either over or under limit K […]

Third Party

Third party – a third party is someone other than the client or a member of the household.  A third party may make payments for a client, be responsible for medical claims, be a collateral contact, or report information about the client.  The client may also receive payments for a third party or make payments […]

Insurance

Insurance – examples of insurance include life, health, dental, vision, accidental death and dismemberment, and insurance for dependents.  Life insurance policies with a cash value are considered as resources for SoonerCare (Medicaid) and TANF.  When a person receives SoonerCare (Medicaid) and has medical insurance, the insurance is the first payer of medical claims.  When an […]