1 Financial Eligibility Requirements for Non-MAGI Groups –

Medicaid and CHIP Program (MACPro) (CMS-10434)

QSSI-MACPro-PRA-S2T

GenIC #15 (Transition from 0938-1148) - Medicaid State Plan Eligibility

OMB: 0938-1188

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

Medicaid and CHIP Program (MACPro)
S2T-Financial Eligibility Requirements for NonMAGI Groups – Territories PRA document
Version 1.0
08/18/2017

Document Number: 214-QSSI-MACPro-PRA-S2T-D
Contract Number: HHSM-500-2007-00024I: HHSM-500-T0014

CMS XLC

Table of Contents

Table of Contents
1. S2T-Financial Eligibility Requirements for Non-MAGI Groups – Territories –
Screenshots ............................................................................................................. 1
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Financial Eligibility Requirements for Non-MAGI Groups – Territories ............ 1

List of Figures
Figure 1: Financial Eligibility Requirements for Non-MAGI Groups – Territories – 1 ....... 1
Figure 2: Financial Eligibility Requirements for Non-MAGI Groups – Territories – 2 ....... 1

S2T-Financial Eligibility Requirements for Non-MAGI Groups – Territories PRA document
Version 1.0
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CMS XLC

S2T-Financial Eligibility Requirements for Non-MAGI Groups – Territories – Screenshots

1. S2T-Financial Eligibility Requirements for Non-MAGI
Groups – Territories – Screenshots
1.1

Financial Eligibility Requirements for Non-MAGI Groups –
Territories

Figure 1: Financial Eligibility Requirements for Non-MAGI Groups – Territories – 1

Figure 2: Financial Eligibility Requirements for Non-MAGI Groups – Territories – 2

S2T-Financial Eligibility Requirements for Non-MAGI Groups – Territories PRA document
Version 1.0
1

08/18/2017


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