Topic: SoonerCare
Special medical status – occurs in certain instances when an individual’s SSP benefit or TANF cash assistance closes and the individual or family remains eligible for medical benefits. For TANF, this occurs when the TANF cash assistance payment would be less than the $10 minimum TANF benefit or when the TANF benefit is frozen while […]
Suspension – means an administrative action to temporarily interrupt receipt of SSP or SoonerCare (Medicaid) benefits.
Revocable trust: means a trust in which the grantor has retained the right to terminate or revoke the trust and reclaim the trust principal and income. Unless a trust is specifically made irrevocable, it is revocable. Even an irrevocable trust is revocable upon the written consent of all living persons with an interest in the […]
Qualified Disabled and Working Individual (QDWI) – means individuals who have lost their Title II Social Security benefits due to excess earnings, but have been allowed to retain Medicare coverage. Policy regarding this term is located at: Public Assistance Procedures (SoonerCare): 340:65-3-1. Determination of eligibility. SoonerCare (Medicaid)[ABD]: 317:35-1-2. Definitions; 317:35-5-63. Agency responsible for determination of […]
State Plan Personal Care – is a SoonerCare (Medicaid) program. When approved, personal care services provide assistance to an individual in carrying out activities of daily living, such as bathing, grooming, and toileting, or in carrying out instrumental activities of daily living, such as preparing meals and doing laundry or errands directly related to the […]
Online Enrollment (OE) – A web-based system developed by the Oklahoma Health Care Authority to determine Medicaid eligibility for certain individuals. Detailed systems information is available under Quest: OHCA Online Enrollment. Policy regarding this term is located at: Public Assistance Procedures (all programs): 340:65-3-1. Determination of eligibility; 340:65-3-6. Cash assistance payment procedures; 340:65-3-8. Continuing eligibility […]
MAGI – acronym for Modified Adjusted Gross Income. Financial eligibility for persons eligible to apply using Online Enrollment (OE) is determined using the modified adjusted gross income on income tax forms. Policy regarding this term is located at: SoonerCare (Medicaid)[OE]: 317:35-5-46. Determination of income and resources for categorical relationship to pregnancy-related services; 317:35-6-1. Scope and […]
Medicaid – is a health insurance program jointly funded by the state and federal governments but managed by the states. This term is used throughout SoonerCare (Medicaid) policy. Chapter 35. Medical Assistance for Adults and Children – Eligibility: 317:35-1-1. Purpose 317:35-1-2. Definition 317:35-1-3. Legal bases Coverage and Exclusions: 317:35-3-1. Payment for Medicaid Eligibility and Countable […]
LOCEU – acronym used for the Oklahoma Health Care Authority’s Level of Care Evaluation Unit.
HCBW – is an acronym for Home and Community Based Waiver services. The services must be approved by Developmental Disabilities Services staff for all DDS waiver services or Aging Services staff for ADvantage waiver services and are paid through the SoonerCare (Medicaid) program. Policy regarding this term is located at: SoonerCare (Medicaid) [ABD]: 317:35-5-41.10. Changes […]