Feb 11 2018

The Medical Access Program – Central Health MAP

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The Medical Access Program

1. For Central Health Eligibility. Effective July 5, 2017, clients who are QHP eligible at next open enrollment make sure to end coverage on 11/15/2017 and tag them QHP Yes 7/5/2017

2. For Central Health Eligibility: Effective May 1, 2017, clients who are QHP eligible at next open enrollment make sure to end coverage on 10/31/2017 and tag them QHP Yes . 5/1/2017

4.For Central Health Eligibility . The Medicare Number field must be completed in the following situations:

  • The individual is eligible /potentially eligible for the Marketplace.
    • Used to determine if individual should receive a QHP tag based on when their Medicare will begin relevant to their next opportunity to enroll (Open Enrollment in the Marketplace).
  • The individual is receiving Social Security Disability and is at or below 100% of the FPIL
    • Used to determine the length of issuance if order to term MAP coverage the last day of the month prior to the month of the individuals Medicare start date.

5. For Central Health Eligibility. When the client s source of income is from RSDI and the proof does not indicate the specific type (Retirement, Survivors/Widows, Disability), the client s verbal declaration of the type of Social Security Benefit they are receiving is acceptable.

  • If the client states the income is Social Security Disability Income (SSDI), issue short term coverage (60 days) and ask the client to return with proof of benefit type and Medicare effective date.

6. Individuals will be referred to Marketplace if: (QHP Tag)

  • LPRs less than 5 years with income below 100% of FPL
    • Except for those clients who will reach their 5 year Legal Permanent Residency anniversary date within the first 5 months of the coverage year may apply for MAP
  • US Citizens or LPRs who are disabled with income between 100-200% of the FPL
    • Except for those whose Medicare effective date is in the first three months of the coverage year may apply for MAP.

8. Beginning 4/17/2017 Central Health Eligibility will no longer be assisting with State Applications at the SEHWC. Central Health Eligibility will continue to issue MAP on Mondays, Tuesdays and Thursdays from 8am-5pm.

9. As of Feb 3rd, 2017 Rosewood Zaragosa Health Center is temporarily close for renovations. The medical team has relocated to Sandra Joy Anderson Health and Wellness Center at 1705 East 11th St. Austin, TX 78702. 2/21/2017

10. For Central Health Eligibility Staff: Applicants in the SMART program will receive homeless status. Clients will be given coverage up to their discharge date or for 6 months if they are planning to stay in Travis County. 1/12/2017


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