The FAQ applies to consumers who were referred by the Marketplace as potentially eligible for Modified Adjusted Gross Income (MAGI)-based Medicaid/CHIP and were referred to their SMA, and who are waiting for their SMA to conduct a final MAGI-based Medicaid/CHIP eligibility determination. This can occur in households where all applicants are found by the Marketplace as potentially eligible for Medicaid/CHIP or in households where some applicants are found eligible for Marketplace coverage and others are potentially Medicaid/CHIP-eligible. Households in the latter scenario will have qualified health plan (QHP)-eligible applicants routed to enroll in coverage with the Marketplace, and applicants assessed as Medicaid/CHIP-eligible will have their application information securely electronically transferred to their SMA for final eligibility determinations and/or enrollment, if eligible. The FAQ can be used to assist consumers navigating these various scenarios.
See FAQs Consumers the FFM Refers to Medicaid and CHIP Agencies.pdf for frequently asked questions.