Scenarios and Examples



Scenario 1
William is 53. He has been receiving $1300 a month in SSDI for a two and a half years. He recently became eligible for Medicare, but was denied QMB/SMLB for being over income. After 5 years of being out of the workforce, the MAP site has assisted William with finding a part time job. However, William has a large number of unpaid medical bills, needs hearing aids and dental work not covered by Medicare, and is afraid his untreated medical issues will hurt his ability to work.

Code: 5a - Options Counseling, potentially Medicaid eligible
 or 3a. - Referral, Medicaid eligible or 6. Level 1 Screen (EID)


Scenario 2
Rosa is 67. She has custody of her grandchild, age 7. She has Medicare and gets $1500 a month in Social Security. She was recently discharged from the hospital and expresses interest in CFC.
Code: 5a - Options Counseling, potentially Medicaid eligible
 or 3a. - Referral, Medicaid eligible (Over 65 parents/caretakers)


Scenario 3
Jane is 35 and is recovering from a serious car accident. She is a single parent to a 15 year old. Jane was just approved for $1700 a month in SSDI and has $10,000 in assets.
Code: 5a - Options Counseling, potentially Medicaid eligible
 or 3a. - Referral, Medicaid eligible (MAGI Medicaid)  


Scenario 4
Angel is 25. She receives Medicare and $800 a month in SSDI. She has two children, but her mother has custody of them and they do not live with her. She would like assistance with medical bills and needs CFC to remain independent in the community.  
Code: 5c - Options Counseling, not Medicaid eligible
 or 3a. - Referral, not Medicaid or 6. Level 1 Screen 


Scenario 5
Patrice is 61. He receives a small amount from social security and $12 from SSI each month. He needs help remaining independent in his home.
Code: 5a - Options Counseling, potentially Medicaid eligible
 or 3a. - Referral, Medicaid eligible or 6. Level 1 Screen (if even $1 of SSI)