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Appendix I Definitions (Rev. 04/01/08)

529 Plan 
A State-sponsored investment program that parents can fund to pay for their child’s college education. The state sets up the plan with an asset management company, and the parents open a 529 account with this asset management company.
Program Area: SSI
Accelerated Life Insurance Payments 
Proceeds paid to a policyholder before the insured nowiki>’</nowiki>s death.
Program Area: SSI

Actuarially Sound The return on a promissory note or annuity is expected within the lifetime of the individual.
Program Area: SSI

Adequate Notice A notice that must be received before the effective date of the change that informs the applicant/beneficiary or the Authorized Representative of action taken.
‘‘‘ Program Area: All ‘‘‘

Advanced Notice Notice of planned action must be mailed to the beneficiary or authorized representative at least 10 days before the date of action, or 5 days prior in the case of fraud.
‘‘‘ Program Area: All ‘‘‘

Aged As defined by the SSA, a person who is 65 years of age or older. An individual is considered aged the month he turns age 65.
‘‘‘ Program Area: SSI ‘‘‘

Alien An alien is an individual who lives in the US but is not a citizen.
‘‘‘ Program Area: All ‘‘‘

Annuity A sum paid yearly or at other specific times in return for the payment of a fixed sum. Annuities may be purchased by an individual or by an employer.
‘‘‘ Program Area: All ‘‘‘

Appeal An appeal is a request of an applicant/ beneficiary or his representative for a review of the action taken on his case.
‘‘‘ Program Area: All ‘‘‘

Appeal Decision A decision reached by the Fair Hearing Officer.
‘‘‘ Program Area: All ‘‘‘

Appeal Summary A detailed summary of case situation, including supporting documents
‘‘‘ Program Area: All ‘‘‘

Applicant A person who signs under penalty of perjury a written application for Medicaid or on whose behalf a written application is made and signed by an authorized representative.
‘‘‘ Program Area: All ‘‘‘

Application An application for Medicaid signed by the applicant or his authorized representative.
‘‘‘ Program Area: All ‘‘‘

Application Process A series of actions leading to a determination of eligibility or ineligibility for Medicaid.
‘‘‘ Program Area: All ‘‘‘

Appraisal A comprehensive estimate of property value.
‘‘‘ Program Area: SSI ‘‘‘

Assisted Living Group Care for a person who cannot remain in his own home but does not yet meet Skilled or Intermediate Level of Care.
‘‘‘ Program Area: SSI ‘‘‘

Authorization Period Period for which all factors of eligibility have been established and the beneficiary is authorized to receive a Medicaid card.
‘‘‘ Program Area: All ‘‘‘

Authorized Representative Any individual who alleges that he is acting in behalf of an applicant/beneficiary.
‘‘‘ Program Area: All ‘‘‘

Automated Notice A notice produced and mailed by MEDS to an applicant/beneficiary based on codes entered by the eligibility worker when action is keyed.
‘‘‘ Program Area: All ‘‘‘

Award Letter A statement to an individual from a governmental or private agency indicating benefits for which he/she is eligible.
‘‘‘ Program Area: All ‘‘‘

Bed Hold Ability for Medicaid to continue vendor payment to a Long Term Care facility for a limited time if certain criteria are met.
‘‘‘ Program Area: SSI ‘‘‘

BENDEX Beneficiary Data Exchange System, a computer printout listing the amount of an individual ’ s Social Security benefits.
‘‘‘ Program Area: All ‘‘‘

Beneficiary A term used to refer to an individual who is eligible for Medicaid.
‘‘‘ Program Area: All ‘‘‘

Black Lung Payments to a disabled worker, dependents, or survivors resulting from exposure to coal dust.
‘‘‘ Program Area: All ‘‘‘

Blue Book Value An official car valuation by the NADA or Kelly Blue Book.
‘‘‘ Program Area: SSI ‘‘‘

Boarder A person who lives with the applicant/beneficiary and pays a set amount for a room and meals.
‘‘‘ Program Area: All ‘‘‘

Brown Lung Benefits Payments made to persons disabled by lung disease resulting from exposure to raw cotton dust.
‘‘‘ Program Area: All ‘‘‘

Budget Group Persons, who are related by blood, adoption or marriage, and whose needs, income and/or resources, are considered in the eligibility determination of one or more persons in the group.
‘‘‘ Program Area: All ‘‘‘

Bureau of Citizenship and Immigrations Services (BCIS) Part of the Department of Homeland Security. As of November 1, 2003, the name has been changed to US Citizenship and Immigration Services (USCIS). Most of the functions it performed were formerly in the jurisdiction of the Immigration and Naturalization Service (INS) that was part of the Department of Justice.
‘‘‘ Program Area: All ‘‘‘

Burial Funds Funds clearly designated for burial related expenses. May include: burial contracts, cash, bank accounts, stocks, bonds, or CD.
‘‘‘ Program Area: SSI ‘‘‘

Burial Insurance Contract whose terms preclude the use of its proceeds for anything other than payment of the insured ’ s burial expenses.
‘‘‘ Program Area: SSI ‘‘‘

Burial Spaces A cemetery plot, niche, casket, urn, mausoleum, or other traditionally used for bodily remains. May also be vaults, markers, or opening and closing of the gravesite.
‘‘‘ Program Area: SSI ‘‘‘

Caretaker Relative The natural or adoptive parent or the specified relative living in the household with the child who is eligible for Medicaid and providing the child ’ s day-to-day care and supervision.
‘‘‘ Program Area: FI ‘‘‘

Case Record A file containing the application and all documents verifying initial and continuing eligibility for members of the assistance unit.
‘‘‘ Program Area: All ‘‘‘

Cash Surrender Value A form of equity value a life insurance policy acquires over time. The amount of money a person may receive if they surrender their Life Insurance Policy before its maturity or the insured ’ s death. Gross Cash Value less any outstanding loans and surrender charges.
‘‘‘ Program Area: SSI ‘‘‘

'Categorical 'Eligibility All persons applying for Medicaid must be categorically eligible. To be categorically eligible for Medicaid, an individual must be: receiving cash assistance such as SSI or Optional State Supplementation (OSS); aged; blind; disabled; a child under age 19; a pregnant woman; a family with a dependent child(ren); or screened for breast or cervical cancer under the Best Chance Network program and found to need treatment for either breast or cervical cancer or pre-cancerous lesions.
‘‘‘ Program Area: All ‘‘‘

Category Change The process of transferring from one payment category of assistance to another.
‘‘‘ Program Area: All ‘‘‘

Certification period The period of time for which assistance is requested and in which all eligibility factors except need and reserve (when applicable) must be met.
‘‘‘ Program Area: All ‘‘‘

Certified Level of Care Medical determination of need for Skilled or Intermediate Nursing Care. It is recommended by a physician. Community Long Term Care (LONG TERM CARE FACILITY) must certify for Medicaid Eligibility. Intermediate Care for the Mentally Retarded is certified through the Dept of Disability and Special Needs (DDSN)
‘‘‘ Program Area: SSI ‘‘‘

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