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Exception Eligibility
Listed in Sections below are the various Exception Eligibility report categories. Seven possible alert messages are generated for clients with records in the Exceptional Eligibility category:
Refer to MEDS HB Chapter 11, for detail of the renewal alerts below.
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Alert # |
Description |
Status |
|---|---|---|
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9530 |
MEDS Established Edwards - Medi-Cal Determination Needed |
Priority Alert |
|
9531 |
Third Edwards Month - Check Medi-Cal Determination Status |
Critical |
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9532 |
Over 3 Edwards Months - Medi-Cal Determination Overdue |
Critical |
|
9533 |
County Established Edwards - Medi-Cal Determination Needed |
Action |
|
9534 |
Second Edwards Month - Check Medi-Cal Determination Status |
Action |
|
9549 |
New Burman Eligible - MEDS Eligibility Update Needed |
Action |
|
9550 |
Ongoing Burman Eligible - MEDS Eligibility Update Overdue |
Critical |
SB87-CWD-CNTY
SB 87 - CWD - County Reported. As a result of the Edwards v. Kizer lawsuit, counties must place CalWORKs beneficiaries who have been discontinued from assistance into a special temporary continuing Medi-Cal Aid Code. This automatic process places clients in Aid Code 38 status until a determination of Medi-Cal eligibility is made by the county and a timely notice of action can be sent to the beneficiary.
Clients with records in this category had Edwards eligibility generated by the County.
Refer to MC HB Chapter 35: Court Orders, for details on Edwards v Kizer.
SB87-CWD-MEDS
SB 87 - CWD - MEDS Reported. As a result of the Edwards v. Kizer lawsuit, counties must place CalWORKs beneficiaries who have been discontinued from assistance into a special temporary continuing Medi-Cal Aid Code. This automatic process places clients in Aid Code 38 status until a determination of Medi-Cal eligibility is made by the county and a timely notice of action can be sent to the beneficiary.
Clients with records in this category had Edwards eligibility generated by MEDS.
MEDS-HOLD-NEW
Exception Eligibility - Burman Hold - New. As a result of the Burman v. Belshe lawsuit, MEDS was modified so clients will not lose their Medi-Cal eligibility without a timely 10-day notification. Eligibility continues until the county resolves the problem.
This is the first month the beneficiary’s record is placed on Burman Hold.
MEDS-HOLD-ONGOING
Exception Eligible - Burman Hold - Ongoing. As a result of the Burman v. Belshe lawsuit, MEDS was modified so clients will not lose their Medi-Cal eligibility without a timely 10-day notification. Eligibility continues until the county resolves the problem.
Beneficiaries are placed in this category when they have been on Burman Hold status for more than one month and the county has not taken action to resolve the problem that generated the Hold.
Related Topics
Renewal MEDS Alerts Tracking Reports