Automated Client Eligibility (ACES) program codes
Revised date
Program | ACES | Description | Scope |
---|---|---|---|
SSI and SSI Related SSI and SSI related also called Aged/Blind/Disabled category Disability is determined by SSA or by NGMA referral to DDDS |
S01 | SSI Recipients | CNP |
S02 | ABD Categorically Needy | CNP | |
S03 | QMB Medicare Savings Program (MSP) Medicare premium and Medicare copays | MSP | |
S04 | QDWI Medicare Savings Program | MSP | |
S05 | SLMB Medicare Savings Program. Medicare Premium only | MSP | |
S06 | QI-1 (SLMB) Medicare Savings Program | MSP | |
S07 | Undocumented Alien - Emergency Related Service Only | ERSO | |
S95 | Medically Needy no Spenddown | MNP | |
S99 | Medically Needy with Spenddown | MNP |
Program | ACES | Description | Scope |
---|---|---|---|
SSI Related living in an Alternative Living Facility (Non Medical Institution) Adult Family Home, boarding home or DDD Group Home |
G03 | Non Institutional Medical in ALF CNP income under the SIL plus under state rate x 31 days + 38.84 | CNP |
G95 | Medically Needy Non Institutional in ALF no Spenddown | MNP | |
G99 | Medically Needy Non Institutional in ALF with Spenddown | MNP |
Program | ACES | Description | Scope |
---|---|---|---|
SSI Related Health Care for Workers w/disability | S08 | Health Care for Workers with Disability CNP Premium based program - Substantial Gainful Activity (SGA) not a factor in Disability determination. | CNP |
Program | ACES | Description | Scope |
---|---|---|---|
Institutional HCBS Waivers (HCS/DDD) and hospice |
L21 | DDD/HCS Waiver on SSI | CNP |
SSI and SSI related | L22 | DDD/HCS Waiver - gross income under the SIL | CNP |
L24 | Undocumented alien/noncitizens LTC - residential placement; must be preapproved by ADSA program manager; Emergency related service only (45 slots) | ERSO - CNP | |
L31 | PACE or Hospice on SSI (effective 10/1/2015) | CNP | |
L32 | PACE or Hospice - SSI related (effective 10/1/2015) | CNP | |
L41 | Roads to Community Living (RCL) on SSI (effective 10/1/2015) | CNP | |
L99 | Roads to Community Living - SSI related (effective 10/1/2015) | CNP | |
Noninstitutional community first choice Personal care services in the community |
L51 | Community First Choice CFC on SSI (effective 10/1/2015) | CNP |
L52 | Community First Choice - SSI-Related at home or in an ALF (effective 10/1/2015) | CNP |
Program | ACES | Description | Scope |
---|---|---|---|
Institutional SSI - related Residing in a medical institution 30 days or more |
L01 | SSI recipient in a Medical Institution - Residing in a medical institution 30 days or more | CNP |
L02 | SSI related CNP in a medical institution income under the SIL | CNP | |
L04 | Undocumented alien/non-citizen LTC must be preapproved by ADSA program manager. Emergency related service only (45 slots) | ERSO - CNP | |
L95 | SSI related Medically Needy no Spenddown Income over the SIL; Income under the state rate | MNP | |
L99 | SSI related Medically Needy with Spenddown; Income over the SIL; income over the state rate but under the private rate; locks into state NF rate | MNP |
Program | ACES | Description | Scope |
---|---|---|---|
Institutional family/children TANF related income/resource rules | K01 | Categorically Needy family in medical institution | CNP |
K03 | Undocumented Alien family in medical institution - Emergency Related Service Only | ERSO | |
K95 | Family LTC Medically Needy no Spenddown in Medical Institution | MNP | |
K99 | Family LTC Medically Needy with Spenddown - in Medical Institution | MNP | |
Pregnancy | P02 | Pregnant 185% of FPL & Postpartum Extension | CNP |
P04 | Undocumented Alien Pregnant Woman | CNP | |
P05 | Family Planning Service Only | Family planning | |
P06 | Take Charge Family Planning Only | ||
P99 | Medically Needy Pregnant Spenddown | MNP | |
Refugee medical assistance | R02 | Transitional 4 month extension | CNP |
R03 | Refugee Categorically needy | CNP |
Program | ACES | Description | Scope |
---|---|---|---|
DCFS/JRA Medical Foster Care |
D01 | SSI Recipient FC/AS/JRA Categorically Needy | CNP |
D02 | FC/AS/JRA Categorically Needy | CN | CNP |
D26 | Title IV-E Federal Foster Care - Under 26 | CN | CNP |
Family related medical assistance | F01 | TANF cash and Medicaid (ended 9/30/2013) | CNP |
F02 | Transitional Medicaid | CNP | |
F03 | Post TANF child/spousal support (4 months max - ended 12/31/2013) | CNP | |
F04 | TANF related | CNP | |
F05 | Newborn | CNP | |
F06 | Categorically needy medical children (effective 1/1/2009, this may be CNP Medicaid children or CNP State funded children) | CNP | |
F07 | Children's health insurance program | CNP | |
F08 | Undocumented alien children (this coverage group ended 12/31/2008 and is merged with the F06 group) | CNP | |
F09 | Undocumented alien - Emergency related service only | ERSO | |
F10 | Interim Categorically needy (2 months max - ended 12/31/2014) | CNP | |
F99 | Medically needy children spenddown | MNP |
Program | ACES | Description | Scope |
---|---|---|---|
MAGI Family Related MA | N01 | MAGI Parent/Caretaker Medicaid; Adult | CNP |
N02 | 12 Month Transitional MAGI Parent/Caretaker Medicaid; Adult | CNP | |
N03 | MAGI Pregnancy | CNP | |
N04 | After Pregnancy | CNP/ABP | |
N05 | MAGI Adult Medicaid; Income =<133% (Medicaid Expansion) | ABP | |
N07 | After pregnancy; not Medicaid eligible during pregnancy | CNP | |
N10 | MAGI Newborn Medical Birth to One Year | CNP | |
N11 | MAGI Children's Medicaid/Age Under 19 | CNP | |
N13 | MAGI Children's Health Insurance Program (CHIP) Children Under 19; Premium Payment Program | CNP | |
N21 | MAGI Parents/Caretaker; Emergency Only; AEM | ERSO | |
N23 | MAGI Pregnancy; Not Lawfully Present | CNP | |
N24 | After pregnancy; not lawfully present | CNP | |
N25 | MAGI Adult Medicaid; Noncitizen - Income =<133% (Medicaid Expansion) AEM | ERSO | |
N27 | After pregnancy; not lawfully present; not Medicaid eligible during pregnancy | CNP | |
N31 | MAGI Children's Medical; Under 19; Noncitizen | State funded CNP | |
N33 | MAGI Children's Health Insurance Program (CHIP): Under 19; Premium Payment Program, Noncitizen | State funded CNP | |
ADATSA State program drug & alcohol TX program | W01 | ADATSA Medical state funded (ended 12/31/2013) | State funded |
W02 | ADATSA Medical state funded (ended 12/31/2013) | State funded | |
W03 | Detox medical state funded (ended 12/31/2013) | State funded |
Program | ACES | Description | Scope |
---|---|---|---|
Medical care services and ABD cash with CN Medicaid | G01 | MCS Medical care services (ended 8/31/2014) | State funded |
A01 | State funded Medical Care Services and ABD Cash Aged/Blind/Disabled | State funded | |
A05 | Medical Care Services non citizen (under 65, incapacitated) | State funded | |
A24 | Medical Care Services non citizen SFA for survivors of certain crimes | State funded | |
G02 |
ABD cash plus either:
|
CNP |
Program | ACES | Description | Scope |
---|---|---|---|
Mental health institutional | I01 | Inpatient psychiatric (mental health - ended 12/31/2013) | CNP |
Breast and Cervical Cancer Program | S30 | Breast and Cervical Cancer (Health Department Approval) | CNP |
Program | ACES | Description | Scope |
---|---|---|---|
Take Charge | P06 | Family Planning (Take Charge) | Family Planning |
Psychiatric inpatient | M99 | Psychiatric indigent inpatient spenddown (MI prior to 7/2003) Mental health ONLY (ended 12/31/2013) |
Inpatient psychiatric hospital only |
Tailored supports for older adults (TSOA) HCS maintains TSOA cases |
T02 | TSOA - No medical benefits and no Medicaid services card issued Pre- Medicaid benefit for the caregiver of a person 55 or older to support the caregiver. For those not eligible for a CN or ABP Medicaid program and not needing or eligible for other LTSS services because of resources. Must meet NFLOC. |
No medical benefits |
Program | ACES | Description | Scope |
---|---|---|---|
Apple Health Eligibility | S20 | Classic Adult Medical 65+; Income = < 138% Apple Health Expansion | AHE - State Funded |
Apple Health Eligibility | N20 | MAGI Adult Medical 19 - 64; Income = 138% Apple Health Expansion | AHE - State Funded |
CNP = Categorically Needy Program MN = Medically Needy ERSO = Emergency Related Services Only (AEM) MSP = Medicare Savings ABP = Alternative Benefit Plan