Topic: Medicaid
Link to SoonerCare Benefit Chart
What is Buy-In? “Buy-in” is the procedure whereby the Oklahoma Health Care Authority (OHCA) pays the client’s Medicare premium through the Centers for Medicare & Medicaid Services (CMS). DHS determines eligibility and oversees operation of Buy-in Program CMS oversees Medicare program Social Security Administration (SSA) enrolls people in Medicare The Buy-in programs are QMB, SLMB […]
Buy-In Process Flowchart 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 […]
If there are any issues with the Buy-In, look over the following items to verify that they are correct on the case: Certification period 12 months Claim number on Bendex (Block B07) Medicare cards are now issued with a new Medicare number that is unique to the beneficiary instead of using SSN-based Health Insurance Claim […]
Link to TEFRA Packet PDF
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 […]
Special Medical is a group of categories that allow clients to continue receiving medical assistance despite their income when specified increases in income are received. All the categories require client to have received the State Supplemental Payment (SSP) at a specified point, but are no longer receiving it because their income has increased. Keep in […]
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MMIS stands for: Medicaid Management Information System. It is used to verify eligibility for medical programs. Access MMIS Extranet from your desktop or from the InfoNet. Refer to article: How Do I Access MMIS Extranet from the InfoNet? On the initial screen of MMIS Extranet Page, click Eligibility Select from 4 options to look up […]
THERE IS NO RESOURCE STANDARD TEST The following apply: 60 month look-back period on all assets Penalty for transfer of assets Rules on annuities, promissory notes, life estates and trusts are the same as for ABD related NOT subject to Medicaid lien on home property Subject to Medicaid Estate Recovery if age 55 older when […]