Medicaid — Scope of Medicaid or CHIP Benefits — Latest in Year

SAS Name
MDCD_RSTRCTD_BNFTS_CD_LTST

This variable indicates the scope of Medicaid or Children’s Health Insurance Program (CHIP) benefits to which a beneficiary is entitled; most recent in the calendar year.

Comments

CCW obtains this directly from the DE RSTRCTD_BNFTS_CD_LTST variable.

Source: T-MSIS DE file

Code Code value
0 Not eligible for Medicaid or (CHIP) during the month
1 Eligible for Medicaid or CHIP (full scope of benefits)
2 Eligible for Medicaid or Medicaid-Expansion CHIP (restricted benefits based on alien status)
3 Eligible for Medicaid (restricted benefits based on Medicare dual-eligibility status; e.g., QMB, SLMB, QDWI, QI)
4 Eligible for Medicaid or CHIP (restricted benefits - pregnancy)
5 Eligible for Medicaid or Medicaid-Expansion CHIP (restricted benefits - not 2, 3, or 4); e.g., substance abuse, medically needy or other
6 Eligible for Medicaid or Medicaid-Expansion CHIP (restricted benefits - family planning)
7 Eligible for Medicaid (alternative package of benchmark-equivalent coverage, as enacted by the Deficit Reduction Act of 2005)
A Eligible for Medicaid and entitled to benefits under the Psychiatric Residential Treatment Facilities Demonstration Grant Program (PRTF); community alternatives to psychiatric resident treatment facilities for children.
D Eligible for Medicaid - Money Follows the Person (MFP) demo
Null/missing Source value is missing, unknown or not Medicaid enrolled