Categories of Eligibility for T-XIX
T-XIX beneficiaries who will be eligible for substance abuse services include:
| Population |
Population Codes |
| AFDC adults and children |
30-36 |
| Poverty Level Eligible |
43-46 |
| Supplemental Security Income |
10-12 |
| Medical Support |
20-22 |
| Working Disabled |
26 |
| Medically Improved |
27 |
| Medical Assistance |
40-42 |
| Breast/Cervical Cancer |
75 |
| Adoption Support |
67 |
| Foster Care |
60-69 |
| MA Child Institution |
73 |
- T-XIX Beneficiaries Not Eligible for the Contract:
- All T-XIX beneficiaries are automatically enrolled for provision of covered T-XIX services under this Contract except for the following excluded eligibility categories:
- T-XIX beneficiaries who reside in Nursing Facilities (NF) or Intermediate Care Facilities for the Mentally Retarded (ICF/MR).
- T-XIX beneficiaries who receive services through the S-CHIP program. Kansas has a stand-alone S-CHIP program.
- Sixth Omnibus Budget Reconciliation Act of 1986 (SOBRA) eligibles for an emergency condition only.
- Individuals participating in the refugee resettlement program.
- Beneficiaries who have an eligibility period that is only retroactive.
- Beneficiaries who reside in an Adult Care Home.
- Beneficiaries who reside in a State Institution.
- Beneficiaries who have not yet met spend-down requirements.
- Beneficiaries who are being treated in a Psychiatric Residential Treatment Facility (PRTF).
<Back