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 | CN |
| S02 | ABD Categorically Needy | CN | |
| S03 | QMB Medicare Savings Program (MSP) Medicare premium and Medicare copayments | MSP | |
| S04 | QDWI Medicare Savings Program | MSP | |
| S05 | SLMB Medicare Savings Program. Medicare Premium only | MSP | |
| S06 | QI-1 (ESLMB) Medicare Savings Program | MSP | |
| S07 | Undocumented Alien. Emergency Related Service Only | ERSO | |
| S95 | Medically Needy no Spenddown | MN | |
| S99 | Medically Needy with Spenddown | MN |
| Program | ACES | Description | Scope |
|---|---|---|---|
|
SSI Related Living in an Alternative Living Facility (Non Medical Institution) Adult Family Home, assisted living facility or DDA Group Home |
G03 | Non Institutional Medical in ALF income under the SIL plus under state rate x 31 days + 38.84 | CN |
| G95 | Medically Needy Non Institutional in ALF no Spenddown | MN | |
| G99 | Medically Needy Non Institutional in ALF with Spenddown | MN |
| Program | ACES | Description | Scope |
|---|---|---|---|
| SSI Related Health Care for Workers w/disability | S08 | Health Care for Workers with Disability Premium based program. Substantial Gainful Activity (SGA) not a factor in Disability determination. | CN |
| Program | ACES | Description | Scope |
|---|---|---|---|
| Institutional HCBS Waivers, PACE, Roads to Community Living, Community First Choice and Hospice SSI related |
L21 | Categorically Needy DDA/HCS Waiver or Hospice on SSI | CN |
| L22 | Categorically Needy DDA/HCS Waiver or Hospice - gross income under the SIL | CN | |
| L24 | State funded LTC for noncitizens - in home or residential placement. Must be preapproved by ALTSA program manager. L04 and L24 is limited funding to 45 slots. | ERSO - CN Scope | |
| L31 | PACE/Hospice on SSI | CN | |
| L32 | PACE/Hospice, SSI related | CN | |
| L41 | Roads to Community Living (RCL) on SSI | CN | |
| L42 | Roads to Community Living (RCL) SSI related | CN | |
| L51 | SSI Non-Institutional CN CFC or MPC | CN | |
| L52 | SSI-Related Non-Institutional CN CFC or MPC | CN | |
| L95 | Medically Needy Hospice in Medical Institution. Income over the SIL - no spenddown | MN | |
| L99 | Medically Needy Hospice in Medical Institution. With Spenddown | MN |
| Program | ACES | Description | Scope |
|---|---|---|---|
| Institutional SSI | L01 | SSI recipient in a Medical Institution - Residing in a medical institution 30 days or more | CN |
| Program | ACES | Description | Scope |
|---|---|---|---|
| Institutional SSI Related Residing in a medical institution 30 days or more |
L02 | SSI related CN-P in a Medical Institution Income under the SIL | CN |
| L04 | State funded LTC for noncitizens - nursing facility placement. Must be preapproved by ALTSA program manager. L04 and L24 program is limited funding to 45 slots. | ERSO - CN scope | |
| L95 | SSI related Medically Needy no Spenddown Income over the SIL. Income under the state rate. | MN | |
| 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 | MN |
| Program | ACES | Description | Scope |
|---|---|---|---|
| MAGI based Institutional | K01 | Categorically Needy MAGI in Medical Institution | CN |
| K03 | Undocumented Alien MAGI in Medical Institution Emergency Related Service Only | ERSO | |
| K95 | MAGI based LTC Medically Needy no Spenddown in Medical Institution | MN | |
| K99 | MAGI based LTC Medically Needy with Spenddown in Medical Institution | MN | |
| P02 | Pregnant 185 FPL & Postpartum Extension | CN | |
| P04 | Undocumented Alien Pregnant Woman | CN scope | |
| P05 | Family Planning Service Only | Family Planning | |
| P06 | Take Charge Family Planning Only | ||
| P99 | Medically Needy Pregnant Women & Postpartum Extension | MN |
| Program | ACES | Description | Scope |
|---|---|---|---|
|
DCFS/JRA Medical Foster Care |
D01 | SSI Recipient FC/AS/JRA Categorically Needy | CN |
| D02 | FC/AS/JRA Categorically Needy | CN | |
| D26 | Title IV-E Federal Foster Care - Under 26 | CN |
| Program | ACES | Description | Scope |
|---|---|---|---|
| MAGI Family Related MA | N01 | MAGI Parent/Caretaker Medicaid; Adult | CN |
| N02 | 12 Month Transitional MAGI Parent/Caretaker Medicaid; Adult | CN | |
| N03 | MAGI Pregnancy | CN | |
| N05 | MAGI Adult Medicaid; Income =<133% (Medicaid Expansion) | ABP | |
| N10 | MAGI Newborn Medical Birth to One Year | CN | |
| N11 | MAGI Children's Medicaid/Age Under 19 | CN | |
| N13 | MAGI Children's Health Insurance Program (CHIP) Children Under 19; Premium Payment Program | CN | |
| N21 | MAGI Parents/Caretaker; Emergency Only; AEM | ERSO | |
| N23 | MAGI Pregnancy; Not Lawfully Present | CN | |
| N25 | MAGI Adult Medicaid; Noncitizen - Income =<133% (Medicaid Expansion) AEM | ERSO | |
| N31 | MAGI Children's Medical; Under 19; Noncitizen | State Funded CN Scope of Care | |
| N33 | MAGI Children's Health Insurance Program (CHIP): Under 19; Premium Payment Program, Noncitizen | State Funded CN Scope of Care |
| Program | ACES | Description | Scope |
|---|---|---|---|
| Medical Care Services | A01 | State funded Medical Care Services and ABD Cash with CN Medicaid, Age >=65 years, or Blind, or Disabled | MCS |
| A05 | State funded Medical Care Services; person does not qualify for Medicaid due to alien status | MCS |
| Program | ACES | Description | Scope |
|---|---|---|---|
| Breast and Cervical Cancer Program | S30 | Breast and Cervical Cancer (Health Department Approval) | CN |
| Program | ACES | Description | Scope |
|---|---|---|---|
| Take Charge | P06 | Family Planning (Take Charge) | Family Planning |
CN = Categorically Needy MN = Medically Needy ERSO = Emergency Related Services Only (AEM) MSP = Medicare Savings ABP = Alternative Benefit Plan