1 Financial Eligibility Requirements for Non-MAGI Groups

Centers for Medicare & Medicaid
Services
CMS eXpedited Life Cycle (XLC)

Medicaid and CHIP Program (MACPro)
S2 - Financial Eligibility Requirements for NonMAGI Groups RU PRA Document
Version 1.0
08/16/2017

Document Number: 181-QSSI-MACPro-R5.1-S2-D
Contract Number: HHSM-500-2007-00024I: HHSM-500-T0014

CMS XLC

Table of Contents

Table of Contents
1. S2 - Financial Eligibility Requirements for Non-MAGI Groups Screenshots ...... 1
1.1
1.2

Package Header and A. Financial Eligibility Methodologies ............................ 1
B. Eligibility Determinations of Aged, Blind and Disabled Individuals, C.
Financial Responsibility of Relatives and D. Additional Information (optional) 2

List of Figures
Figure 1: Package Header and Section A ....................................................................... 1
Figure 2: Section B, Section C and Section D ................................................................. 2

List of Tables
No table of figures entries found.

S2 - Financial Eligibility Requirements for Non-MAGI Groups RU PRA Document Version
1.0
i

08/16/2017

CMS XLC

Package Header and A. Financial Eligibility Methodologies

1. S2 - Financial Eligibility Requirements for Non-MAGI
Groups Screenshots
1.1

Package Header and A. Financial Eligibility Methodologies

Figure 1: Package Header and Section A

S2 - Financial Eligibility Requirements for Non-MAGI Groups RU PRA Document Version
1.0
1

08/16/2017

CMS XLC
B. Eligibility Determinations of Aged, Blind and Disabled Individuals, C. Financial Responsibility of Relatives and D. Additional
Information (optional)

1.2

B. Eligibility Determinations of Aged, Blind and Disabled
Individuals, C. Financial Responsibility of Relatives and D.
Additional Information (optional)

Figure 2: Section B, Section C and Section D

S2 - Financial Eligibility Requirements for Non-MAGI Groups RU PRA Document Version
1.0
2

08/16/2017