Title: Par
Author: Michele Gee
Last saved by: raddington
Company: DHS

Bismarck, North Dakota	MANUAL LETTER #3129	April 1, 2008

Par. 1.  Material Transmitted and Purpose – Transmitted with this Manual Letter are changes to Service Chapter 510-05 - Medicaid Eligibility Factors.  

Groups Covered Under Medicaid 510-05-30-05
This section is updated to reflect a new effective date.

2.	The optional categorically needy group includes:

f.	Children with Disabilities under age 19 (including the month attaining age 19) who meet medically needy nonfinancial criteria, have income at or below 200% of the poverty level, and are not eligible for full Medicaid benefits under any other provision. Effective ~~March~~ April 2008.

State Residence 510-05-35-85
This section is updated to report South Dakota’s withdrawal from the reciprocal residency agreement.

8.	If an interstate reciprocal residency agreement has been entered into between this state and another state pursuant to 42 CFR 435.403(k), the state of residence of an affected individual is the state determined under that agreement.

North Dakota has an interstate reciprocal residence agreement with ~~ten~~ nine states. The agreement provides that individuals of any age institutionalized in one of these states are considered a resident of the state in which they are institutionalized.  

	The states with whom we have the agreement are:
	California	~~South Dakota~~	Tennessee
	Florida	New Mexico	Texas
	Kentucky	Ohio	Wisconsin
	Pennsylvania

General Information 510-05-58-05
This section is updated to reflect a new effective date.

The Children with Disabilities coverage allows options to families of children with disabilities under age 19, who are not eligible for Medicaid or who are eligible for Medicaid and have a recipient liability, to buy into Medicaid. This coverage became effective in North Dakota on ~~March~~ April 1, 2008.

Income Levels 510-05-85-40
This section is updated with the new family member income level for spousal impoverishment cases and the new poverty related income levels. 

2.	Medically needy income levels.
d.	Family member income level. The income level for each ineligible family member in a spousal impoverishment case is $~~571~~584 effective April 200~~7~~8 ($~~550~~571 effective April 200~~6~~7).
3.	Poverty income levels.
a.	Qualified Medicare Beneficiaries 

Number of Persons | Monthly Income Level
1 | $ ~~851~~867
2 | ~~1141~~1167
3 | ~~1431~~1467
4 | ~~1721~~1767
5 | ~~2011~~2067
6 | ~~2301~~2367
7 | ~~2591~~2667
8 | ~~2881~~2967
Effective April 1, 200~~7~~8
For each person in the Medicaid unit above eight, add $~~290~~300 to the monthly amount.

b.	Specified Low-Income Medicare Beneficiaries 
Number of Persons | Monthly Income Level
1 | $~~1021~~1040
2 | ~~1369~~1400
3 | ~~1717~~1760
4 | ~~2065~~2120
5 | ~~2413~~2480
6 | ~~2761~~2840
7 | ~~3109~~3200
8 | ~~3457~~3560
Effective April 1, 200~~7~~8
For each person in the Medicaid unit above eight, add $~~348~~360 to the monthly amount.

c.	Pregnant women and children under age six. 
Number of Persons | Monthly Income Level
1 | $~~1132~~1153
2 | ~~1518~~1552
3 | ~~1903~~1951
4 | ~~2289~~2350
5 | ~~2675~~2749
6 | ~~3061~~3148
7 | ~~3446~~3547
8 | ~~3832~~3946
Effective April 1, 200~~7~~8
 
For each person in the Medicaid unit above eight, add $~~386~~399 to the monthly amount.

d.	Qualifying Individuals. 
Number of Persons | Monthly Income Level
1 | $ ~~1149~~1170
2 | ~~1541~~1575
3 | ~~1932~~1980
4 | ~~2324~~2385
5 | ~~2715~~2790
6 | ~~3107~~3195
7 | ~~3498~~3600
8 | ~~3890~~4005
Effective April 1, 200~~7~~8
For each person in the Medicaid unit above eight, add $~~392~~405 to the monthly amount.
e.	
Transitional Medicaid Benefits. 
Number of Persons | Monthly Income Level
1 | $~~1575~~1603
2 | ~~2111~~2158
3 | ~~2648~~2713
4 | ~~3184~~3268
5 | ~~3721~~3823
6 | ~~4257~~4378
7 | ~~4794~~4933
8 | ~~5330~~5488
Effective April 1, 200~~7~~8
For each person in the Medicaid unit above eight, add $~~537~~555 to the monthly amount.
f.	
Workers with Disabilities.  
Number of Persons | Monthly Income Level
1 | $~~1914~~1950
2 | ~~2566~~2625
3 | ~~3219~~3300
4 | ~~3871~~3975
5 | ~~4524~~4650
6 | ~~5176~~5325
7 | ~~5829~~6000
8 | ~~6481~~6675
Effective April 1, 200~~7~~8
For each person in the Medicaid unit above eight, add $~~652~~675 to the monthly amount.
g.	
Children with Disabilities. 
Number of Persons | Monthly Income Level
1 | $~~1702~~1733
2 | ~~2282~~2333
3 | ~~2862~~2933
4 | ~~3442~~3533
5 | ~~4022~~4133
6 | ~~4602~~4733
7 | ~~5182~~5333
8 | ~~5762~~5933
Effective ~~March~~April 1, 2008
For each person in the Medicaid unit above eight, add $~~580~~600 to the monthly amount.

Par. 2.   Effective Date – This manual letter is effective for the benefit month of April 2008.

Carol K. Olson, Executive Director	Manual Letter #3129
North Dakota Department of Human Services	Page  of