SPD WG G.9 Decision Notice Preparation Tips

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APD Worker Guide

G.9 Decision Notice Preparation Tips (Somali)

Updated 1/1/20

Disclaimer: When preparing decision notices, you should be very careful to be sure that the situation for your specific client is accurately reflected in the notice and that you have carefully chosen all applicable rules that support your decision. You should be sure to add any rules that might be missing from these samples when your client’s situation is not the exact same situations as what these examples were designed for.

Note: The red text in italics and underlined will need to either be entered based on the specific scenario (such as the effective date or income amount) or selected from the listed choices.

MEDICAL: Closure Reduction Denial Miscellaneous

SNAP: Closure Reduction Denial

SERVICE: Translations not currently available

SPECIAL NEEDS: Closure Reduction Denial

TRANSLATIONS: English Spanish Russian Simplified Chinese Traditional Chinese Vietnamese

Eligibility Issues

Medical Closure

Situation

Medicare Recipient

Non-Medicare Client

1. Whereabouts unknown - no need to refer to 5503 prior to closure (SDS 540)

Waxaan helnay warqad boosto oo la soo celiyay oo loogu talagalay cinwaanka oo tilmaamaysa in aad guurtay oo aadan ka tegin cinwaan loo sii gudbiyo. Maadaama aanu awoodi weynay in aanu ku helno, waxaanu xiraynaa faa’iidooyinkaaga caafimaad laga bilaabo insert closure effective date mm/dd/yy. OAR 410-120-1210; 461-170-0011(3)(d)(E); 461-175-0210(2); 461-105-0020

If client was OSIPM and/or QMB-BAS add:

Ujeedooyinka dhanka macluumaadka ah KALIYA: Maadaama aad helaysay faa’iidooyinka Medicaid oo dheeraad ku ahaa Medicare aad leedahay iyo faa’dooyinka Medicaid oo joogsanaya, waxaad leedahay waxa loo yaqaan xuquuqda Arrinka la Dammaanad Qaaday “Guaranteed Issue” (GI). Tani macnaheedu waa in aad haysato 63 maalmood ka dib taariikhda faa’iidooyinkaagu joogsadaan in aad isqorto qorshaha Medigap Dheeraadka ah. Fadlan la xiriir Barnaamijka Taageerada Faa'iidooyinka Caymiska Caafimaad ee Dadka Waayeelka ah (SHIBA) 1-800-722-4134 wixii macluumaad dheeraad ah. Xeerka Maamulka Oregon 836-052-0142(2)(a) ayaa dejiya cida u qalanta xuquuqda “Arrinka la Dammaanad Qaaday”.

2. Move out of state (Residency) - no need to refer to 5503 prior to closure (SDS 540)

Note: For SNAP, no notice is required when the filing group moves out of state. See 461-175-0200 and 461-175-0210

Waaxdu waxay faa’iidooyinkaaga caafimaad joojin doonta insert closure effective date mm/dd/yy. Hada ka dib ma tihid qof degan Oregon. Waa in aad deganaataa si aad u hesho faa’iidooyinka barnaamijyada Oregon. OAR 410-120-1210, 410-200-0200(1); 461-120-0010(1); 461-120-0030; 461-165-0030(2); 461-120-0050; 461-175-0210(1)(a)(A)(B)

If client was OSIPM and/or QMB-BAS add:

3a. Closure of OSIPM - Client is no longer eligible for SERVICES, does not qualify for any APD medical benefits, 7210 was returned, and MAGI was denied (SDS 540)

Send a separate 540 for services. Additionally, for in-home services, send a DHS 4105 to the HCW prior to ending services.

Do not send notice and close medical until after 5503 determines eligibility for MAGI medical. If MAGI is approved, 5503 will close the APD medical case and no notice is necessary.

Adeegyada daryeelka ee gurigaaga iyo bulshada ku saleysan waa la joojiyay laga bilaabo insert services closure effective date mm/dd/yy waxaanad heshay ogeysiin gooni ku saabsan talaabadani. Iyadoo oo aan la laheyn adeegyada daryeelka guriga ama bulshada ku saleysan hada ka dib uma qalantid Barnaamijka Dakhliga Dheeraadka ah ee Oregon - Caafimaadka (OSIPM) iyada oo ay faa’iidooyinkaagu joogsan doonaan laga bilaabo insert OSIPM closure effective date mm/dd/yy. Si loogu qalmo OSIPM aan laheyn adeegyada daryeelka ee guriga iyo bulshada ku saleysan, dakhligaaga la isku dheelitiray waa in uu ka hooseeyaa heerka dakhli ee barnaamijka. Dakhligaaga dhan $insert adjusted income wuxuu kaa dhigayaa in aad ka kor marto heerka dakhli ee la isku dheelitiray ee OSIPM. Dakhligaagu wuxuu sidoo kale kaa dhigayaa in aad ka kor marto heerka dakhli ee la isku dheelitiray ee loogu talagalay Barnaamijyada Lacag Kaydsashada ee Medicare (QMB, SMB, SMF) ee bixiya kharashyada jeebka laga bixinayo ee Medicare. Laga bilaabo taariikhda dhaqangalka ee kor ku qoran, adiga ayaa mus’uul ka noqon doona lacagaha qaybta kaaga soo aada Medicare (Medicare premiums), copay-ga iyo lacagaha caymiska laga jaro (deductibles). Uma qalantid barnaamijyada gargaarka caafimaad ee ay maamusho Dadka Waayeelka ah ee Naafada ah (APD). Si loogu qalmo Barnaamijka Dakhliga Caafimaad ee Dheeraadka ah ee Oregon (OSIPM), waa in ay da’daadu tahay 65 jir ama ka wayn tahay, aadan indho qabin, ama leedahay naafanimo buuxinaysa heerarka u yaala Social Security-ga ISLA MARKAANA leedahay u qalmid la aqbalay ama la dhowray ama aad ku siman tahay xadka u yaala dakhliga iyo ilaha. Si loogu qalmo Barnaamijyada Lacag Kaydsashada ee Medicare (QMB, SMB, SMF) waa in aad leedahay Medicare Part A isla markaana leedahay dakhli ku siman xadka u yaala barnaamijka la oggol yahay. Waa in aad sidoo kale buuxisaa dhammaan shuruudaha looga baahan yahay u qalmida waxyaalaha aan dhaqaalaha ku xirnayn oo aad dhammeystirtaa arjiga codsi iyo nidaamka caddeynta si aad aad ugu qalanto barnaamijyada caafimaad ee APD. Waxaad heli doontaa ogeysiin gooni oo ku saabsan u qalmidaada barnaamijyada kale ee Medicaid ee uu bixiyo Maamulka Caafimaadka Oregon.

OAR 410-120-1210; 461-001-0000(3); 461-155-0250; 461-110-0210; 461-110-0310; 461-110-0410; 461-110-0530(2) and (4); 461-115-0010(1),(2),(3),(6)(7); 461-115-0020; 461-115-0230(5); 461-115-0610(1),(2),(3); 461-115-0700; 461-120-0315; 461-120-0330(1),(3); 461-120-0345; 461-120-0510(1),(4),(5),(6),(7); 461-125-0310; 461-125-0330; 461-125-0350; 461-125-0370; 461-135-0010; 461-135-0730; 461-135-0745; 461-135-0750; 461-135-0771; 461-135-0780; 461-135-0790; 461-135-0800; 461-135-0820; 461-135-0830; 461-155-0290; 461-155-0295; 461-160-0010(3),(4),(5); 461-160-0015(3),(4),(5); 461-160-0540; 461-160-0550; 461-160-0551; 461-160-0552; 461-170-0130; 461-180-0085

Do not send notice and close medical until after 5503 determines eligibility for MAGI medical. If MAGI is approved, 5503 will close the OSIPM case and no notice is necessary.

3b. Closure of OSIPM - Client is no longer eligible for SERVICES, does not qualify for any APD medical benefits, and client did not return 7210 (SDS 540)

Send a separate 540 for services. Additionally, for in-home services, send a DHS 4105 to the HCW prior to ending services.

Adeegyada daryeelka ee gurigaaga iyo bulshada ku saleysan waa la joojiyay laga bilaabo insert services closure effective date mm/dd/yy waxaanad heshay ogeysiin gooni ku saabsan talaabadani. Iyadoo oo aan la laheyn adeegyada daryeelka guriga ama bulshada ku saleysan hada ka dib uma qalantid Barnaamijka Dakhliga Dheeraadka ah ee Oregon - Caafimaadka (OSIPM) iyada oo ay faa’iidooyinkaaga caafimaad ayjoogsan doonaan laga bilaabo insert OSIPM closure effective date mm/dd/yy. Si loogu qalmo OSIPM aan laheyn adeegyada daryeelka ee guriga iyo bulshada ku saleysan, dakhligaaga la isku dheelitiray waa in uu ka hooseeyaa heerka dakhli ee barnaamijka. Dakhligaaga dhan $insert adjusted income wuxuu kaa dhigayaa in aad ka kor marto heerka dakhli ee la isku dheelitiray ee OSIPM. Dakhligaagu wuxuu sidoo kale kaa dhigayaa in aad ka kor marto heerka dakhli ee la isku dheelitiray ee loogu talagalay Barnaamijyada Lacag Kaydsashada ee Medicare (QMB, SMB, SMF) ee bixiya kharashyada jeebka laga bixinayo ee Medicare. Laga bilaabo taariikhda dhaqangalka ee kor ku qoran, adiga ayaa mus’uul ka noqon doona lacagaha qaybta kaaga soo aada Medicare (Medicare premiums), copay-ga iyo lacagaha caymiska laga jaro (deductibles). Uma qalantid barnaamijyada gargaarka caafimaad ee ay maamusho Dadka Waayeelka ah ee Naafada ah (APD). Si loogu qalmo Barnaamijka Dakhliga Caafimaad ee Dheeraadka ah ee Oregon (OSIPM), waa in ay da’daadu tahay 65 jir ama ka wayn tahay, aadan indho qabin, ama leedahay naafanimo buuxinaysa heerarka u yaala Social Security-ga ISLA MARKAANA leedahay u qalmid la aqbalay ama la dhowray ama aad ku siman tahay xadka u yaala dakhliga iyo ilaha. Si loogu qalmo Barnaamijyada Lacag Kaydsashada ee Medicare (QMB, SMB, SMF) waa in aad leedahay Medicare Part A isla markaana leedahay dakhli ku siman xadka u yaala barnaamijka la oggol yahay. Waa in aad sidoo kale buuxisaa dhammaan shuruudaha looga baahan yahay u qalmida waxyaalaha aan dhaqaalaha ku xirnayn oo aad dhammeystirtaa arjiga codsi iyo nidaamka caddeynta si aad aad ugu qalanto barnaamijyada caafimaad ee APD. Taariikhdu markay ahayd insert date pended for 7210 mm/dd/yy waxaanu codsanay in aad buuxiso oo aad soo celiso arjiga si uu kuu qiimeeyo Maamulka Caafimaadka Oregon kaasi oo loogu talagalay barnaamijyada kale ee Medicaid. Waxaan ku siinay ilaa insert 7210 due date mm/dd/yy si aad u dhammeystirto talaabadani. Ma aadan soo celin arjiga; sidaa darteed, Maamulka Caafimaadka Oregon go’aan kama gaari karo u qalmidaada barnaamijyada kale ee Medicaid.

OAR 410-120-1210; 461-001-0000(3); 461-155-0250; 461-110-0210; 461-110-0310; 461-110-0410; 461-110-0530(2),(4); 461-115-0010(1),(2),(3); 461-115-0020; 461-115-0230(5); 461-115-0610(1),(2),(3); 461-115-0700; 461-120-0315; 461-120-0330(1),(3); 461-120-0345, 461-120-0510(1),(4),(5),(6),(7); 461-125-0310; 461-125-0330; 461-125-0350; 461-125-0370; 461-135-0010; 461-135-0730; 461-135-0745; 461-135-0750; 461-135-0771; 461-135-0780; 461-135-0790; 461-135-0800; 461-135-0820; 461-135-0830; 461-155-0290; 461-155-0295; 461-160-0010(3),(4),(5); 461-160-0015(3),(4),(5); 461-160-0540, 461-160-0550, 461-160-0551, 461-160-0552; 461-170-0130; 461-180-0085

Adeegyada daryeelka ee gurigaaga iyo bulshada ku saleysan waa la joojiyay laga bilaabo insert services closure effective date mm/dd/yy waxaanad heshay ogeysiin gooni ku saabsan talaabadani. Iyadoo oo aan la laheyn adeegyada daryeelka guriga ama bulshada ku saleysan hada ka dib uma qalantid Barnaamijka Dakhliga Dheeraadka ah ee Oregon - Caafimaadka (OSIPM) iyada oo ay faa’iidooyinkaaga caafimaad ayjoogsan doonaan laga bilaabo insert OSIPM closure effective date mm/dd/yy. Si loogu qalmo OSIPM aan laheyn adeegyada daryeelka ee guriga iyo bulshada ku saleysan, dakhligaaga la isku dheelitiray waa in uu ka hooseeyaa heerka dakhli ee barnaamijka. Dakhligaaga dhan $insert adjusted income wuxuu kaa dhigayaa in aad ka kor marto heerka dakhli ee la isku dheelitiray ee OSIPM. Uma qalantid barnaamijyada gargaarka caafimaad ee ay maamusho Dadka Waayeelka ah ee Naafada ah (APD). Si loogu qalmo Barnaamijka Dakhliga Caafimaad ee Dheeraadka ah ee Oregon (OSIPM), waa in ay da’daadu tahay 65 jir ama ka wayn tahay, aadan indho qabin, ama leedahay naafanimo buuxinaysa heerarka u yaala Social Security-ga ISLA MARKAANA leedahay u qalmid la aqbalay ama la dhowray ama aad ku siman tahay xadka u yaala dakhliga iyo ilaha. Si loogu qalmo Barnaamijyada Lacag Kaydsashada ee Medicare (QMB, SMB, SMF) waa in aad leedahay Medicare Part A isla markaana leedahay dakhli ku siman xadka u yaala barnaamijka la oggol yahay. Waa in aad sidoo kale buuxisaa dhammaan shuruudaha looga baahan yahay u qalmida waxyaalaha aan dhaqaalaha ku xirnayn oo aad dhammeystirtaa arjiga codsi iyo nidaamka caddeynta si aad aad ugu qalanto barnaamijyada caafimaad ee APD. Taariikhdu markay ahayd insert date pended for 7210 mm/dd/yy waxaanu codsanay in aad buuxiso oo aad soo celiso arjiga si uu kuu qiimeeyo Maamulka Caafimaadka Oregon kaasi oo loogu talagalay barnaamijyada kale ee Medicaid. Waxaan ku siinay ilaa insert 7210 due date mm/dd/yy si aad u dhammeystirto talaabadani. Ma aadan soo celin arjiga; sidaa darteed, Maamulka Caafimaadka Oregon go’aan kama gaari karo u qalmidaada barnaamijyada kale ee Medicaid.

4. Failure to comply with annual medical review process –no referral to 5503 necessary (SDS 540)

Faa’iidooyinkaaga caafimaad waxay joogsan doonaan laga bilaabo insert closure effective date mm/dd/yy. Waa in aan dib u eegnaa dacwadadaada 12 biloodba mar si loo go’aamiyo in aad buuxiso shuruudaha loo baahan yahay Medicaid. Dib u eegistaadu waqtigeedu wuxuu ku aadanaa insert review due date mm/dd/yy. Taariikhdu markay ahayd insert date pended mm/dd/yy waxaanu codsanay in aad nala soo xiriirto si loo qabto balan/loo buuxiyo arjiga aanu bixinay. Waxaan ku siinay ilaa insert pend due date mm/dd/yy si aad u dhammeystirto talaabadani. Nala aadan soo xiriirin/ma aadan dhammeystiri wareysiga/ma aadan soo celin arjiga; sidaa darteed, ma go’amin karno u qalmidaada sii socodka Medicaid. Laga bilaabo taariikhda dhaqangalka ee kor ku qoran, adiga ayaa mus’uul ka noqon doona lacagaha qaybta kaaga soo aada Medicare (Medicare premiums) ee ay Waaxdu bixinaysay.

OAR 410-120-1210; 461-105-0020; 461-115-0230; 461-115-0430; (EPD add: 461-115-0540)

If client was OSIPM and/or QMB-BAS add:

OAR 410-120-1210; 461-105-0020; 461-115-0230; 461-115-0430; (EPD add: 461-115-0540)

5. Failure to provide requested verification, no referral to 5503 is necessary (SDS 540)

Taariikhdu markay ahayd insert date pended mm/dd/yy, waxaanu codsanay caddeyn kaa socoto oo ku saabsan insert verification type. Macluumaadkani wuxuu waqtigiisu ku ekaa insert pend due date mm/dd/yy. Ilaa iyo hada, ma aynaan helin caddeytan la codsaday. Iyada oo sababtu tahay anaga oo aan helin macluumaadkan, faa’iidooyinkaaga caafimaad waxay joogsan doonaan laga bilaabo insert closure effective date mm/dd/yy. Laga bilaabo taariikhda dhaqangalka ee kor ku qoran, adiga ayaa mus’uul ka noqon doona lacagaha qaybta kaaga soo aada Medicare (Medicare premiums) ee ay Waaxdu bixinaysay.

OAR 410-120-1210;, 461-105-0020; 461-115-0010(1),(2),(3); 461-115-0190(1), 461-115-0430(2),(3); 461-115-0610(1),(3); 461-115-0700

If client was OSIPM and/or QMB-BAS add:

OAR 410-120-1210;, 461-105-0020; 461-115-0010(1),(2),(3); 461-115-0190(1), 461-115-0430(2),(3); 461-115-0610(1),(3); 461-115-0700

6a. Closure of OSIPM-EPD for failure to make monthly participant fee, client is not eligible for any APD medical, 7210 was returned, and MAGI was denied (SDS 540)

Do not send notice and close medical until after 5503 determines eligibility for MAGI medical. If MAGI is approved, 5503 will close the APD medical case and no notice is necessary.

Marka aad tahay qof hela barnaamijka Qofka Shaqeeya ee Naafanimada leh (EPD waxaa lagaaga baahan yahay in aad bil kasta bixiso kharashka ka qayb qaadashada. Iyada oo ay ku saleysan tahay dakhliga dhan $insert countable income, waa in aad bixisaa $insert participant fee amount bil kasta si aad u hesho u qalmida EPD. Bixinta lacagtan waxay ku aadan tahay bil kasta 10-deeda. Ma aadan samayn lacagta la bixiyo bishii ee loogu talagalay bisha (bilaha) insert month fee unpaid mm/yyyy. Sidaa darteed, faa’iidooyinkaaga caafimaad waxay joogsan doonaan laga bilaabo insert closure effective date mm/dd/yy. Laga bilaabo taariikhda dhaqangalka ee kor ku qoran, adiga ayaa mus’uul ka noqon doona lacagaha qaybta kaaga soo aada Medicare (Medicare premiums) ee ay Waaxdu bixinaysay. Uma qalantid barnaamijyada gargaarka caafimaad ee ay maamusho Dadka Waayeelka ah ee Naafada ah (APD). Si loogu qalmo Barnaamijka Dakhliga Caafimaad ee Dheeraadka ah ee Oregon (OSIPM), waa in ay da’daadu tahay 65 jir ama ka wayn tahay, aadan indho qabin, ama leedahay naafanimo buuxinaysa heerarka u yaala Social Security-ga ISLA MARKAANA leedahay u qalmid la aqbalay ama la dhowray ama aad ku siman tahay xadka u yaala dakhliga iyo ilaha. Si loogu qalmo Barnaamijyada Lacag Kaydsashada ee Medicare (QMB, SMB, SMF) waa in aad leedahay Medicare Part A isla markaana leedahay dakhli ku siman xadka u yaala barnaamijka la oggol yahay. Waa in aad sidoo kale buuxisaa dhammaan shuruudaha looga baahan yahay u qalmida waxyaalaha aan dhaqaalaha ku xirnayn oo aad dhammeystirtaa arjiga codsi iyo nidaamka caddeynta si aad aad ugu qalanto barnaamijyada caafimaad ee APD. Waxaad heli doontaa ogeysiin gooni oo ku saabsan u qalmidaada barnaamijyada kale ee Medicaid ee uu bixiyo Maamulka Caafimaadka Oregon.

OAR 410-120-1210; 461-001-0035; 461-135-0725; 461-160-0800; 461-110-0210; 461-110-0310; 461-110-0410; 461-110-0530(2),(4); 461-115-0010(1),(2),(3); 461-115-0020; 461-115-0230(5); 461-115-0540; 461-115-0610(1),(2),(3); 461-115-0700; 461-120-0315; 461-120-0330(1),(3); 461-120-0345; 461-120-0510(1) and (4),(5),(6),(7); 461-125-0310; 461-125-0330; 461-125-0350; 461-125-0370; 461-135-0010; 461-135-0730; 461-135-0745; 461-135-0750; 461-135-0771; 461-135-0780; 461-135-0790; 461-135-0800; 461-135-0820; 461-135-0830; 461-155-0250; 461-155-0290; 461-155-0295; 461-160-0010(3),(4),(5); 461-160-0015(3),(4),(5); 461-160-0540; 461-160-0550; 461-160-0551; 461-160-0552; 461-170-0130; 461-180-0085

Marka aad tahay qof hela barnaamijka Qofka Shaqeeya ee Naafanimada leh (EPD waxaa lagaaga baahan yahay in aad bil kasta bixiso kharashka ka qayb qaadashada. Iyada oo ay ku saleysan tahay dakhliga dhan $insert countable income, waa in aad bixisaa $insert participant fee amount bil kasta si aad u hesho u qalmida EPD. Bixinta lacagtan waxay ku aadan tahay bil kasta 10-deeda. Ma aadan samayn lacagta la bixiyo bishii ee loogu talagalay bisha (bilaha) insert month fee unpaid mm/yyyy. Sidaa darteed, faa’iidooyinkaaga caafimaad waxay joogsan doonaan laga bilaabo insert closure effective date mm/dd/yy. Uma qalantid barnaamijyada gargaarka caafimaad ee ay maamusho Dadka Waayeelka ah ee Naafada ah (APD). Si loogu qalmo Barnaamijka Dakhliga Caafimaad ee Dheeraadka ah ee Oregon (OSIPM), waa in ay da’daadu tahay 65 jir ama ka wayn tahay, aadan indho qabin, ama leedahay naafanimo buuxinaysa heerarka u yaala Social Security-ga ISLA MARKAANA leedahay u qalmid la aqbalay ama la dhowray ama aad ku siman tahay xadka u yaala dakhliga iyo ilaha. Si loogu qalmo Barnaamijyada Lacag Kaydsashada ee Medicare (QMB, SMB, SMF) waa in aad leedahay Medicare Part A isla markaana leedahay dakhli ku siman xadka u yaala barnaamijka la oggol yahay. Waa in aad sidoo kale buuxisaa dhammaan shuruudaha looga baahan yahay u qalmida waxyaalaha aan dhaqaalaha ku xirnayn oo aad dhammeystirtaa arjiga codsi iyo nidaamka caddeynta si aad aad ugu qalanto barnaamijyada caafimaad ee APD. Waxaad heli doontaa ogeysiin gooni oo ku saabsan u qalmidaada barnaamijyada kale ee Medicaid ee uu bixiyo Maamulka Caafimaadka Oregon.

6b. Closure of OSIPM-EPD for failure to make monthly participant fee, client is not eligible for any APD medical, and client did not return 7210 (SDS 540)

Marka aad tahay qof hela barnaamijka Qofka Shaqeeya ee Naafanimada leh (EPD waxaa lagaaga baahan yahay in aad bil kasta bixiso kharashka ka qayb qaadashada. Iyada oo ay ku saleysan tahay dakhliga dhan $insert countable income, waa in aad bixisaa $insert participant fee amount bil kasta si aad u hesho u qalmida EPD. Bixinta lacagtan waxay ku aadan tahay bil kasta 10-deeda. Ma aadan samayn lacagta la bixiyo bishii ee loogu talagalay bisha (bilaha) insert month fee unpaid mm/yyyy; sidaa darteed, faa’iidooyinkaaga caafimaad waxay joogsan doonaan laga bilaabo insert closure effective date mm/dd/yy. Laga bilaabo taariikhda dhaqangalka ee kor ku qoran, adiga ayaa mus’uul ka noqon doona lacagaha qaybta kaaga soo aada Medicare (Medicare premiums) ee ay Waaxdu bixinaysay. Uma qalantid barnaamijyada gargaarka caafimaad ee ay maamusho Dadka Waayeelka ah ee Naafada ah (APD). Si loogu qalmo Barnaamijka Dakhliga Caafimaad ee Dheeraadka ah ee Oregon (OSIPM), waa in ay da’daadu tahay 65 jir ama ka wayn tahay, aadan indho qabin, ama leedahay naafanimo buuxinaysa heerarka u yaala Social Security-ga ISLA MARKAANA leedahay u qalmid la aqbalay ama la dhowray ama aad ku siman tahay xadka u yaala dakhliga iyo ilaha. Si loogu qalmo Barnaamijyada Lacag Kaydsashada ee Medicare (QMB, SMB, SMF) waa in aad leedahay Medicare Part A isla markaana leedahay dakhli ku siman xadka u yaala barnaamijka la oggol yahay. Waa in aad sidoo kale buuxisaa dhammaan shuruudaha looga baahan yahay u qalmida waxyaalaha aan dhaqaalaha ku xirnayn oo aad dhammeystirtaa arjiga codsi iyo nidaamka caddeynta si aad aad ugu qalanto barnaamijyada caafimaad ee APD. Waxaa intaa dheer, taariikhdu markay ahayd insert date pended for 7210 mm/dd/yy waxaanu codsanay in aad buuxiso oo aad soo celiso arjiga si uu kuu qiimeeyo Maamulka Caafimaadka Oregon kaasi oo loogu talagalay barnaamijyada kale ee Medicaid. Waxaan ku siinay ilaa insert 7210 due date mm/dd/yy si aad u dhammeystirto talaabadani. Ma aadan soo celin arjiga; sidaa darteed, Maamulka Caafimaadka Oregon go’aan kama gaari karo u qalmidaada barnaamijyada kale ee Medicaid.

OAR 410-120-1210; 461-001-0035; 461-135-0725; 461-160-0800; 461-110-0210; 461-110-0310; 461-110-0410; 461-110-0530(2),(4); 461-115-0010(1),(2),(3); 461-115-0020; 461-115-0230(5); 461-115-0540; 461-115-0610(1),(2),(3); 461-115-0700; 461-120-0315; 461-120-0330(1),(3); 461-120-0345; 461-120-0510(1),(4),(5),(6),(7); 461-125-0310; 461-125-0330; 461-125-0350; 461-125-0370; 461-135-0010; 461-135-0730; 461-135-0745; 461-135-0750; 461-135-0771; 461-135-0780; 461-135-0790; 461-135-0800; 461-135-0820; 461-135-0830; 461-155-0250; 461-155-0290; 461-155-0295; 461-160-0010(3),(4),(5); 461-160-0015(3),(4),(5); 461-160-0540; 461-160-0550; 461-160-0551; 461-160-0552; 461-170-0130; 461-180-0085

Marka aad tahay qof hela barnaamijka Qofka Shaqeeya ee Naafanimada leh (EPD waxaa lagaaga baahan yahay in aad bil kasta bixiso kharashka ka qayb qaadashada. Iyada oo ay ku saleysan tahay dakhliga dhan $insert countable income, waa in aad bixisaa $insert participant fee amount bil kasta si aad u hesho u qalmida EPD. Bixinta lacagtan waxay ku aadan tahay bil kasta 10-deeda. Ma aadan samayn lacagta la bixiyo bishii ee loogu talagalay bisha (bilaha) insert month fee unpaid mm/yyyy; sidaa darteed, faa’iidooyinkaaga caafimaad waxay joogsan doonaan laga bilaabo insert closure effective date mm/dd/yy. Uma qalantid barnaamijyada gargaarka caafimaad ee ay maamusho Dadka Waayeelka ah ee Naafada ah (APD). Si loogu qalmo Barnaamijka Dakhliga Caafimaad ee Dheeraadka ah ee Oregon (OSIPM), waa in ay da’daadu tahay 65 jir ama ka wayn tahay, aadan indho qabin, ama leedahay naafanimo buuxinaysa heerarka u yaala Social Security-ga ISLA MARKAANA leedahay u qalmid la aqbalay ama la dhowray ama aad ku siman tahay xadka u yaala dakhliga iyo ilaha. Si loogu qalmo Barnaamijyada Lacag Kaydsashada ee Medicare (QMB, SMB, SMF) waa in aad leedahay Medicare Part A isla markaana leedahay dakhli ku siman xadka u yaala barnaamijka la oggol yahay. Waa in aad sidoo kale buuxisaa dhammaan shuruudaha looga baahan yahay u qalmida waxyaalaha aan dhaqaalaha ku xirnayn oo aad dhammeystirtaa arjiga codsi iyo nidaamka caddeynta si aad aad ugu qalanto barnaamijyada caafimaad ee APD. Waxaa intaa dheer, taariikhdu markay ahayd insert date pended for 7210 mm/dd/yy waxaanu codsanay in aad buuxiso oo aad soo celiso arjiga si uu kuu qiimeeyo Maamulka Caafimaadka Oregon kaasi oo loogu talagalay barnaamijyada kale ee Medicaid. Waxaan ku siinay ilaa insert 7210 due date mm/dd/yy si aad u dhammeystirto talaabadani. Ma aadan soo celin arjiga; sidaa darteed, Maamulka Caafimaadka Oregon go’aan kama gaari karo u qalmidaada barnaamijyada kale ee Medicaid.

OAR 410-120-1210; 461-001-0035; 461-135-0725; 461-160-0800; 461-110-0210; 461-110-0310; 461-110-0410; 461-110-0530(2),(4); 461-115-0010(1),(2),(3); 461-115-0020; 461-115-0230(5); 461-115-0540; 461-115-0610(1),(2),(3); 461-115-0700; 461-120-0315; 461-120-0330(1),(3); 461-120-0345; 461-120-0510(1),(4),(5),(6),(7); 461-125-0310; 461-125-0330; 461-125-0350; 461-125-0370; 461-135-0010; 461-135-0730; 461-135-0745; 461-135-0750; 461-135-0771; 461-135-0780; 461-135-0790; 461-135-0800; 461-135-0820; 461-135-0830; 461-155-0250; 461-155-0290; 461-155-0295; 461-160-0010(3),(4),(5); 461-160-0015(3),(4),(5); 461-160-0540; 461-160-0550; 461-160-0551; 461-160-0552; 461-170-0130; 461-180-0085

7a. Closure of OSIPM - Loss of SSI, client is not entitled to any APD medical benefits, 7210 was returned, and MAGI was denied (SDS 540)

Note: Before referring, make sure to evaluate client for ALL protected OSIPM groups (1619B, DAC, etc.)

Do not send notice and close medical until after 5503 determines eligibility for MAGI medical. If MAGI is approved, 5503 will close the APD medical case and no notice is necessary.

Hada ka dib uma qalantid Barnaamijka Dakhliga Dheeraadka ah ee Oregon-Caafimaadka (OSIPM) laga bilaabo insert closure effective date mm/dd/yy sababta oo ah hada ka dib ma helaysid faa’iidooyinka SSI iyada oo dakhliga aad ka hesho income source ee dhan $monthly income wuxuu kaa dhigayaa in aad ka kor marto heerka dakhli ee la isku dheelitiray ee OSIPM. Dakhligaagu wuxuu sidoo kale kaa dhigayaa in aad ka kor marto heerka dakhli ee la isku dheelitiray ee loogu talagalay barnaamijka U qalmida ka Faa’iidaysiga Medicare (QMB) ee bixiya lacagaha qaybta kaaga soo aada Medicare (Medicare premiums), copay-ga iyo lacagaha caymiska laga jaro (deductibles). Laga bilaabo taariikhda dhaqangalka ee kor ku qoran, adiga ayaa mus’uul ka noqon doona lacagaha qaybta kaaga soo aada Medicare (Medicare premiums) ee ay Waaxdu bixinaysay. Uma qalantid barnaamijyada gargaarka caafimaad ee ay maamusho Dadka Waayeelka ah ee Naafada ah (APD). Si loogu qalmo Barnaamijka Dakhliga Caafimaad ee Dheeraadka ah ee Oregon (OSIPM), waa in ay da’daadu tahay 65 jir ama ka wayn tahay, aadan indho qabin, ama leedahay naafanimo buuxinaysa heerarka u yaala Social Security-ga ISLA MARKAANA leedahay u qalmid la aqbalay ama la dhowray ama aad ku siman tahay xadka u yaala dakhliga iyo ilaha. Si loogu qalmo Barnaamijyada Lacag Kaydsashada ee Medicare (QMB, SMB, SMF) waa in aad leedahay Medicare Part A isla markaana leedahay dakhli ku siman xadka u yaala barnaamijka la oggol yahay. Waa in aad sidoo kale buuxisaa dhammaan shuruudaha looga baahan yahay u qalmida waxyaalaha aan dhaqaalaha ku xirnayn oo aad dhammeystirtaa arjiga codsi iyo nidaamka caddeynta si aad aad ugu qalanto barnaamijyada caafimaad ee APD. Waxaad heli doontaa ogeysiin gooni oo ku saabsan u barnaamijyada kale ee Medicaid ee uu bixiyo Maamulka Caafimaadka Oregon.

OAR 410-120-1210; 461-001-0000(3); 461-135-0010; 461-155-0250; 461-110-0210; 461-110-0310; 461-110-0410; 461-110-0530(2),(4); 461-115-0010(1),(2),(3); 461-115-0020; 461-115-0230(5); 461-115-0540; 461-115-0610(1),(2),(3); 461-115-0700; 461-120-0315; 461-120-0330(1),(3); 461-120-0345; 461-120-0510(1),(4),(5),(6),(7); 461-125-0310; 461-125-0330; 461-125-0350; 461-125-0370; 461-135-0730; 461-135-0745; 461-135-0750; 461-135-0771; 461-135-0780; 461-135-0790; 461-135-0800; 461-135-0820; 461-135-0830; 461-155-0290; 461-155-0295; 461-160-0010(3),(4),(5); 461-160-0015(3),(4),(5); 461-160-0540; 461-160-0550; 461-160-0551; 461-160-0552; 461-170-0130; 461-180-0085

7b. Closure of OSIPM - Loss of SSI, client is not entitled to any APD medical benefits, and client did not return 7210 (SDS 540)

Note: Note: Before referring make sure to evaluate client for ALL protected OSIPM groups (1619B, DAC, etc.)

Hada ka dib uma qalantid Barnaamijka Dakhliga Dheeraadka ah ee Oregon-Caafimaadka (OSIPM) laga bilaabo insert closure effective date mm/dd/yy sababta oo ah hada ka dib ma helaysid faa’iidooyinka SSI iyada oo dakhliga aad ka hesho insert income source ee dhan $insert monthly income wuxuu kaa dhigayaa in aad ka kor marto heerka dakhli ee la isku dheelitiray ee OSIPM. Dakhligaagu wuxuu sidoo kale kaa dhigayaa in aad ka kor marto heerka dakhli ee la isku dheelitiray ee loogu talagalay barnaamijka U qalmida ka Faa’iidaysiga Medicare (QMB) ee bixiya lacagaha qaybta kaaga soo aada Medicare (Medicare premiums), copay-ga iyo lacagaha caymiska laga jaro (deductibles). Laga bilaabo taariikhda dhaqangalka ee kor ku qoran, adiga ayaa mus’uul ka noqon doona lacagaha qaybta kaaga soo aada Medicare (Medicare premiums) ee ay Waaxdu bixinaysay. Uma qalantid barnaamijyada gargaarka caafimaad ee ay maamusho Dadka Waayeelka ah ee Naafada ah (APD). Si loogu qalmo Barnaamijka Dakhliga Caafimaad ee Dheeraadka ah ee Oregon (OSIPM), waa in ay da’daadu tahay 65 jir ama ka wayn tahay, aadan indho qabin, ama leedahay naafanimo buuxinaysa heerarka u yaala Social Security-ga ISLA MARKAANA leedahay u qalmid la aqbalay ama la dhowray ama aad ku siman tahay xadka u yaala dakhliga iyo ilaha. Si loogu qalmo Barnaamijyada Lacag Kaydsashada ee Medicare (QMB, SMB, SMF) waa in aad leedahay Medicare Part A isla markaana leedahay dakhli ku siman xadka u yaala barnaamijka la oggol yahay. Waa in aad sidoo kale buuxisaa dhammaan shuruudaha looga baahan yahay u qalmida waxyaalaha aan dhaqaalaha ku xirnayn oo aad dhammeystirtaa arjiga codsi iyo nidaamka caddeynta si aad ugu qalanto barnaamijyada caafimaad ee APD. Waxaa intaa dheer, taariikhdu markay ahayd insert date 7210 sent mm/dd/yy waxaanu codsanay in aad buuxiso oo aad soo celiso arjiga si uu kuu qiimeeyo Maamulka Caafimaadka Oregon kaasi oo loogu talagalay barnaamijyada kale ee Medicaid. Waxaan ku siinay ilaa insert 7210 due date mm/dd/yy si aad u dhammeystirto talaabadani. Ma aadan soo celin arjiga; sidaa darteed, Maamulka Caafimaadka Oregon go’aan kama gaari karo u qalmidaada barnaamijyada kale ee Medicaid.

OAR 410-120-1210; 461-001-0000(3); 461-135-0010; 461-155-0250; 461-110-0210; 461-110-0310; 461-110-0410; 461-110-0530(2),(4); 461-115-0010(1),(2),(3); 461-115-0020; 461-115-0230(5); 461-115-0540; 461-115-0610(1),(2),(3); 461-115-0700; 461-120-0315; 461-120-0330(1),(3); 461-120-0345, 461-120-0510(1),(4),(5),(6)(7); 461-125-0310; 461-125-0330; 461-125-0350; 461-125-0370; 461-135-0730; 461-135-0745; 461-135-0750; 461-135-0771; 461-135-0780; 461-135-0790; 461-135-0800; 461-135-0820; 461-135-0830; 461-155-0290; 461-155-0295; 461-160-0010(3),(4),(5); 461-160-0015(3),(4),(5); 461-160-0540; 461-160-0550; 461-160-0551; 461-160-0552; 461-170-0130; 461-180-0085

Hada ka dib uma qalantid Barnaamijka Dakhliga Dheeraadka ah ee Oregon-Caafimaadka (OSIPM) laga bilaabo insert closure effective date mm/dd/yy sababta oo ah hada ka dib ma helaysid faa’iidooyinka SSI iyada oo dakhliga aad ka hesho insert income source ee dhan $insert monthly income wuxuu kaa dhigayaa in aad ka kor marto heerka dakhli ee la isku dheelitiray ee OSIPM. Uma qalantid barnaamijyada gargaarka caafimaad ee ay maamusho Dadka Waayeelka ah ee Naafada ah (APD). Si loogu qalmo Barnaamijka Dakhliga Caafimaad ee Dheeraadka ah ee Oregon (OSIPM), waa in ay da’daadu tahay 65 jir ama ka wayn tahay, aadan indho qabin, ama leedahay naafanimo buuxinaysa heerarka u yaala Social Security-ga ISLA MARKAANA leedahay u qalmid la aqbalay ama la dhowray ama aad ku siman tahay xadka u yaala dakhliga iyo ilaha. Si loogu qalmo Barnaamijyada Lacag Kaydsashada ee Medicare (QMB, SMB, SMF) waa in aad leedahay Medicare Part A isla markaana leedahay dakhli ku siman xadka u yaala barnaamijka la oggol yahay. Waa in aad sidoo kale buuxisaa dhammaan shuruudaha looga baahan yahay u qalmida waxyaalaha aan dhaqaalaha ku xirnayn oo aad dhammeystirtaa arjiga codsi iyo nidaamka caddeynta si aad ugu qalanto barnaamijyada caafimaad ee APD. Waxaa intaa dheer, taariikhdu markay ahayd insert date 7210 sent mm/dd/yy waxaanu codsanay in aad buuxiso oo aad soo celiso arjiga si uu kuu qiimeeyo Maamulka Caafimaadka Oregon kaasi oo loogu talagalay barnaamijyada kale ee Medicaid. Waxaan ku siinay ilaa insert 7210 due date mm/dd/yy si aad u dhammeystirto talaabadani. Ma aadan soo celin arjiga; sidaa darteed, Maamulka Caafimaadka Oregon go’aan kama gaari karo u qalmidaada barnaamijyada kale ee Medicaid.

OAR 410-120-1210; 461-001-0000(3); 461-135-0010; 461-155-0250; 461-110-0210; 461-110-0310; 461-110-0410; 461-110-0530(2),(4); 461-115-0010(1),(2),(3); 461-115-0020; 461-115-0230(5); 461-115-0540; 461-115-0610(1),(2),(3); 461-115-0700; 461-120-0315; 461-120-0330(1),(3); 461-120-0345, 461-120-0510(1),(4),(5),(6)(7); 461-125-0310; 461-125-0330; 461-125-0350; 461-125-0370; 461-135-0730; 461-135-0745; 461-135-0750; 461-135-0771; 461-135-0780; 461-135-0790; 461-135-0800; 461-135-0820; 461-135-0830; 461-155-0290; 461-155-0295; 461-160-0010(3),(4),(5); 461-160-0015(3),(4),(5); 461-160-0540; 461-160-0550; 461-160-0551; 461-160-0552; 461-170-0130; 461-180-0085

8a. Closure of OSIPM - Client no longer meets DAC eligibility criteria due to resources, is not eligible for any other APD medical program, 7210 was returned, and MAGI was denied (SDS 540)

Do not send notice and close medical until after 5503 determines eligibility for MAGI medical. If MAGI is approved, 5503 will close the APD medical case and no notice is necessary.

Faa’iidooyinkaaga caafimaad waxay joogsan doonaan laga bilaabo insert closure effective date mm/dd/yy. Hada ka dib uma qalantid Barnaamijka Dakhliga Dheeraadka ah ee Oregon-Caafimaadka (OSIPM) in uu noqdo Ilmaha Weyn ee Naafada ah (DAC) ahaan. Si loogu qalmo in OSIPM uu noqdo DAC ahaan, waa in aad buuxisaa shuruudaha looga baahan yahay Sugidda Dakhliga ee Kabista ah (SSI) marka laga reebo xaqiiqda ah in aad helaysid faa’iidadaada Social Security-ga ee ilmaha weyn ee naafada ah. Waxaad hada haysataa kheyraad ka badan xadka u yaala kheyraadka la oggol yahay oo dhan $2,000 kaasi oo loogu talagalay barnaamijka SSI; sidaa darteed, uma aadan qalmi lahayn SSI xataa haddii aadan helaynin faa’iidada ilmaha weyn ee naafada ah. Iyada oo aan la laheyn xaaladan la ilaalinayo ‘protected status’, waxaad hada ka kor martay xadka u yaala kheyraadka ee dhan $2,000 ee loogu talagalay OSIPM. Dakhligaaga la isku dheelitiray wuxuu sidoo kale kaa dhigayaa in aad ka kor marto dakhliga la isku dheelitiray ee loogu talagalay Barnaamijyada Lacag Kaydsashada ee Medicare (QMB, SMB, SMF) ee bixiya kharashyada la xiriira Medicare. Laga bilaabo taariikhda dhaqangalka ee kor ku qoran, adiga ayaa mus’uul ka noqon doona lacagaha qaybta kaaga soo aada Medicare (Medicare premiums), copay-ga iyo lacagaha caymiska laga jaro (deductibles). Uma qalantid barnaamijyada gargaarka caafimaad ee ay maamusho Dadka Waayeelka ah ee Naafada ah (APD). Si loogu qalmo Barnaamijka Dakhliga Caafimaad ee Dheeraadka ah ee Oregon (OSIPM), waa in ay da’daadu tahay 65 jir ama ka wayn tahay, aadan indho qabin, ama leedahay naafanimo buuxinaysa heerarka u yaala Social Security-ga ISLA MARKAANA leedahay u qalmid la aqbalay ama la dhowray ama aad ku siman tahay xadka u yaala dakhliga iyo ilaha. Si loogu qalmo Barnaamijyada Lacag Kaydsashada ee Medicare (QMB, SMB, SMF) waa in aad leedahay Medicare Part A isla markaana leedahay dakhli ku siman xadka u yaala barnaamijka la oggol yahay. Waa in aad sidoo kale buuxisaa dhammaan shuruudaha looga baahan yahay u qalmida waxyaalaha aan dhaqaalaha ku xirnayn oo aad dhammeystirtaa arjiga codsi iyo nidaamka caddeynta si aad ugu qalanto barnaamijyada caafimaad ee APD. Waxaad heli doontaa ogeysiin gooni oo ku saabsan barnaamijyada kale ee Medicaid ee uu bixiyo Maamulka Caafimaadka Oregon.

OAR 410-120-1210; 461-001-0000(3); 461-135-0830(4); 461-160-0010(3); 461-160-0015(3); 461-110-0210; 461-110-0310; 461-110-0410; 461-110-0530(2),(4); 461-115-0010(1),(2),(3); 461-115-0020; 461-115-0230(5); 461-115-0540; 461-115-0610(1),(2),(3); 461-115-0700; 461-120-0315; 461-120-0330(1)(3); 461-120-0345; 461-120-0510(1),(4),(5),(6),(7); 461-125-0310; 461-125-0330; 461-125-0350; 461-125-0370; 461-135-0730; 461-135-0745; 461-135-0750; 461-135-0771; 461-135-0780; 461-135-0790; 461-135-0800; 461-135-0820; 461-155-0250; 461-155-0290; 461-155-0295; 461-160-0540; 461-160-0550; 461-160-0551; 461-160-0552; 461-170-0130; 461-180-0085

Faa’iidooyinkaaga caafimaad waxay joogsan doonaan laga bilaabo insert closure effective date mm/dd/yy. Hada ka dib uma qalantid Barnaamijka Dakhliga Dheeraadka ah ee Oregon-Caafimaadka (OSIPM) in uu noqdo Ilmaha Weyn ee Naafada ah (DAC) ahaan. Si loogu qalmo in OSIPM uu noqdo DAC ahaan, waa in aad buuxisaa shuruudaha looga baahan yahay Sugidda Dakhliga ee Kabista ah (SSI) marka laga reebo xaqiiqda ah in aad helaysid faa’iidadaada Social Security-ga ee ilmaha weyn ee naafada ah. Waxaad hada haysataa kheyraad ka badan xadka u yaala kheyraadka la oggol yahay oo dhan $2,000 kaasi oo loogu talagalay barnaamijka SSI; sidaa darteed, uma aadan qalmi lahayn SSI xataa haddii aadan helaynin faa’iidada ilmaha weyn ee naafada ah. Iyada oo aan la laheyn xaaladan la ilaalinayo ‘protected status’, waxaad hada ka kor martay xadka u yaala kheyraadka ee dhan $2,000 ee loogu talagalay OSIPM. Uma qalantid barnaamijyada gargaarka caafimaad ee ay maamusho Dadka Waayeelka ah ee Naafada ah (APD). Si loogu qalmo Barnaamijka Dakhliga Caafimaad ee Dheeraadka ah ee Oregon (OSIPM), waa in ay da’daadu tahay 65 jir ama ka wayn tahay, aadan indho qabin, ama leedahay naafanimo buuxinaysa heerarka u yaala Social Security-ga ISLA MARKAANA leedahay u qalmid la aqbalay ama la dhowray ama aad ku siman tahay xadka u yaala dakhliga iyo ilaha. Si loogu qalmo Barnaamijyada Lacag Kaydsashada ee Medicare (QMB, SMB, SMF) waa in aad leedahay Medicare Part A isla markaana leedahay dakhli ku siman xadka u yaala barnaamijka la oggol yahay. Waa in aad sidoo kale buuxisaa dhammaan shuruudaha looga baahan yahay u qalmida waxyaalaha aan dhaqaalaha ku xirnayn oo aad dhammeystirtaa arjiga codsi iyo nidaamka caddeynta si aad ugu qalanto barnaamijyada caafimaad ee APD. Waxaad heli doontaa ogeysiin gooni oo ku saabsan barnaamijyada kale ee Medicaid ee uu bixiyo Maamulka Caafimaadka Oregon.

8b. Closure of OSIPM - Client no longer meets DAC eligibility criteria due to excess income and no longer receiving DAC benefits, is not eligible for any other APD medical program, and client did not return 7210 (SDS 540)

Faa’iidooyinkaaga caafimaad waxay joogsan doonaan laga bilaabo insert closure effective date mm/dd/yy. Hada ka dib uma qalantid Barnaamijka Dakhliga Dheeraadka ah ee Oregon-Caafimaadka (OSIPM) in uu noqdo Ilmaha Weyn ee Naafada ah (DAC) ahaan. Si loogu qalmo in OSIPM uu noqdo DAC ahaan, waa in aad buuxisaa shuruudaha looga baahan yahay Sugidda Dakhliga ee Kabista ah (SSI) marka laga reebo xaqiiqda ah in aad helaysid faa’iidadaada Social Security-ga ee ilmaha weyn ee naafada ah. Hada ka dib ma helaysid faa’iidooyinka Social Security-ga ee ilmaha weyn ee naafada ah. Iyada oo aan la laheyn xaaladan la ilaalinayo ‘protected status’, waxaad hada ka kor martay xadka u yaala dakhliga la isku dheelitiray ee dhan $783 ee loogu talagalay OSIPM. Dakhligaagu wuxuu sidoo kale kaa dhigayaa in aad ka kor marto dakhliga la isku dheelitiray ee loogu talagalay Barnaamijyada Lacag Kaydsashada ee Medicare ee bixiya kharashyada jeebka laga bixinayo ee Medicare. Laga bilaabo taariikhda dhaqangalka ee kor ku qoran, adiga ayaa mus’uul ka noqon doona lacagaha qaybta kaaga soo aada Medicare (Medicare premiums), copay-ga iyo lacagaha caymiska laga jaro (deductibles). Uma qalantid barnaamijyada gargaarka caafimaad ee ay maamusho Dadka Waayeelka ah ee Naafada ah (APD). Si loogu qalmo Barnaamijka Dakhliga Caafimaad ee Dheeraadka ah ee Oregon (OSIPM), waa in ay da’daadu tahay 65 jir ama ka wayn tahay, aadan indho qabin, ama leedahay naafanimo buuxinaysa heerarka u yaala Social Security-ga ISLA MARKAANA leedahay u qalmid la aqbalay ama la dhowray ama aad ku siman tahay xadka u yaala dakhliga iyo ilaha. Si loogu qalmo Barnaamijyada Lacag Kaydsashada ee Medicare (QMB, SMB, SMF) waa in aad leedahay Medicare Part A isla markaana leedahay dakhli ku siman xadka u yaala barnaamijka la oggol yahay. Waa in aad sidoo kale buuxisaa dhammaan shuruudaha looga baahan yahay u qalmida waxyaalaha aan dhaqaalaha ku xirnayn oo aad dhammeystirtaa arjiga codsi iyo nidaamka caddeynta si aad ugu qalanto barnaamijyada caafimaad ee APD. Waxaa intaa dheer, taariikhdu markay ahayd insert date 7210 sent mm/dd/yy waxaanu codsanay in aad buuxiso oo aad soo celiso arjiga si uu kuu qiimeeyo Maamulka Caafimaadka Oregon kaasi oo loogu talagalay barnaamijyada kale ee Medicaid. Waxaan ku siinay ilaa insert 7210 due date mm/dd/yy si aad u dhammeystirto talaabadani. Ma aadan soo celin arjiga; sidaa darteed, Maamulka Caafimaadka Oregon go’aan kama gaari karo u qalmidaada barnaamijyada kale ee Medicaid.

OAR 410-120-1210; 461-001-0000(3); 461-135-0830(4); 461-155-0250; 461-155-0290; 461-155-0295; 461-110-0210; 461-110-0310; 461-110-0410; 461-110-0530(2),(4); 461-115-0010(1),(2),(3); 461-115-0020; 461-115-0230(5); 461-115-0540; 461-115-0610(1),(2),(3); 461-115-0700; 461-120-0315; 461-120-0330(1),(3); 461-120-0345; 461-120-0510(1),(4),(5),(6),(7); 461-125-0310; 461-125-0330; 461-125-0350; 461-125-0370; 461-135-0730; 461-135-0745; 461-135-0750; 461-135-0771; 461-135-0780; 461-135-0790; 461-135-0800; 461-135-0820; 461-160-0010(3),(4),(5); 461-160-0015(3),(4),(5); 461-160-0540; 461-160-0550; 461-160-0551; 461-160-0552; 461-170-0130; 461-180-0085

Faa’iidooyinkaaga caafimaad waxay joogsan doonaan laga bilaabo insert closure effective date mm/dd/yy. Hada ka dib uma qalantid Barnaamijka Dakhliga Dheeraadka ah ee Oregon-Caafimaadka (OSIPM) in uu noqdo Ilmaha Weyn ee Naafada ah (DAC) ahaan. Si loogu qalmo in OSIPM uu noqdo DAC ahaan, waa in aad buuxisaa shuruudaha looga baahan yahay Sugidda Dakhliga ee Kabista ah (SSI) marka laga reebo xaqiiqda ah in aad helaysid faa’iidadaada Social Security-ga ee ilmaha weyn ee naafada ah. Hada ka dib ma helaysid faa’iidooyinka Social Security-ga ee ilmaha weyn ee naafada ah. Iyada oo aan la laheyn xaaladan la ilaalinayo ‘protected status’, waxaad hada ka kor martay xadka u yaala dakhliga la isku dheelitiray ee dhan $783 ee loogu talagalay OSIPM. Uma qalantid barnaamijyada gargaarka caafimaad ee ay maamusho Dadka Waayeelka ah ee Naafada ah (APD). Si loogu qalmo Barnaamijka Dakhliga Caafimaad ee Dheeraadka ah ee Oregon (OSIPM), waa in ay da’daadu tahay 65 jir ama ka wayn tahay, aadan indho qabin, ama leedahay naafanimo buuxinaysa heerarka u yaala Social Security-ga ISLA MARKAANA leedahay u qalmid la aqbalay ama la dhowray ama aad ku siman tahay xadka u yaala dakhliga iyo ilaha. Si loogu qalmo Barnaamijyada Lacag Kaydsashada ee Medicare (QMB, SMB, SMF) waa in aad leedahay Medicare Part A isla markaana leedahay dakhli ku siman xadka u yaala barnaamijka la oggol yahay. Waa in aad sidoo kale buuxisaa dhammaan shuruudaha looga baahan yahay u qalmida waxyaalaha aan dhaqaalaha ku xirnayn oo aad dhammeystirtaa arjiga codsi iyo nidaamka caddeynta si aad ugu qalanto barnaamijyada caafimaad ee APD. Waxaa intaa dheer, taariikhdu markay ahayd insert date 7210 sent mm/dd/yy waxaanu codsanay in aad buuxiso oo aad soo celiso arjiga si uu kuu qiimeeyo Maamulka Caafimaadka Oregon kaasi oo loogu talagalay barnaamijyada kale ee Medicaid. Waxaan ku siinay ilaa insert 7210 due date mm/dd/yy si aad u dhammeystirto talaabadani. Ma aadan soo celin arjiga; sidaa darteed, Maamulka Caafimaadka Oregon go’aan kama gaari karo u qalmidaada barnaamijyada kale ee Medicaid.

OAR 410-120-1210; 461-001-0000(3); 461-135-0830(4); 461-155-0250; 461-110-0210; 461-110-0310; 461-110-0410; 461-110-0530(2),(4); 461-115-0010(1),(2),(3); 461-115-0020; 461-115-0230(5); 461-115-0540; 461-115-0610(1),(2),(3); 461-115-0700; 461-120-0315; 461-120-0330(1),(3); 461-120-0345; 461-120-0510(1),(4),(5),(6),(7); 461-125-0310; 461-125-0330; 461-125-0350; 461-125-0370; 461-135-0730; 461-135-0745; 461-135-0750; 461-135-0771; 461-135-0780; 461-135-0790; 461-135-0800; 461-135-0820; 461-155-0290; 461-155-0295; 461-160-0010(3),(4),(5); 461-160-0015(3),(4),(5); 461-160-0540; 461-160-0550; 461-160-0551; 461-160-0552; 461-170-0130; 461-180-0085

9a. Closure of OSIPM (or OSIPM and QMB) for being over income, client is not eligible for any APD medical program, 7210 was returned, and MAGI was denied (SDS 540)

Do not send notice and close medical until after 5503 determines eligibility for MAGI medical. If MAGI is approved, 5503 will close the APD medical case and no notice is necessary.

Faa’iidooyinkaaga caafimaad waxay joogsan doonaan laga bilaabo insert closure effective date mm/dd/yy. Hada ka dib uma qalantid Barnaamijka Dakhliga Caafimaad ee Dheeraadka ah ee Oregon (OSIPM) sababta oo ah dakhligaaga cusub ee aad ka hesho insert income source ee dhan $insert monthly income wuxuu kaa dhigayaa in aad ka kor marto heerka dakhli ee la isku dheelitiray ee OSIPM. Dakhligaagu wuxuu sidoo kale kaa dhigayaa in aad ka kor marto heerka dakhli ee la isku dheelitiray ee loogu talagalay barnaamijka U qalmida ka Faa’iidaysiga Medicare (QMB) ee bixiya lacagaha qaybta kaaga soo aada Medicare (Medicare premiums), copay-ga iyo lacagaha caymiska laga jaro (deductibles). Laga bilaabo taariikhda dhaqangalka ee kor ku qoran, adiga ayaa mus’uul ka noqon doona lacagaha qaybta kaaga soo aada Medicare (Medicare premiums) ee ay Waaxdu bixinaysay. Uma qalantid barnaamijyada gargaarka caafimaad ee ay maamusho Dadka Waayeelka ah ee Naafada ah (APD). Si loogu qalmo Barnaamijka Dakhliga Caafimaad ee Dheeraadka ah ee Oregon (OSIPM), waa in ay da’daadu tahay 65 jir ama ka wayn tahay, aadan indho qabin, ama leedahay naafanimo buuxinaysa heerarka u yaala Social Security-ga ISLA MARKAANA leedahay u qalmid la aqbalay ama la dhowray ama aad ku siman tahay xadka u yaala dakhliga iyo ilaha. Si loogu qalmo Barnaamijyada Lacag Kaydsashada ee Medicare (QMB, SMB, SMF) waa in aad leedahay Medicare Part A isla markaana leedahay dakhli ku siman xadka u yaala barnaamijka la oggol yahay. Waa in aad sidoo kale buuxisaa dhammaan shuruudaha looga baahan yahay u qalmida waxyaalaha aan dhaqaalaha ku xirnayn oo aad dhammeystirtaa arjiga codsi iyo nidaamka caddeynta si aad aad ugu qalanto barnaamijyada caafimaad ee APD. Waxaad heli doontaa ogeysiin gooni oo ku saabsan u barnaamijyada kale ee Medicaid ee uu bixiyo Maamulka Caafimaadka Oregon.

OAR 410-120-1210; 461-001-0000(3); 461-155-0250; 461-155-0290; 461-110-0210; 461-110-0310; 461-110-0410; 461-110-0530(2),(4); 461-115-0010(1),(2),(3); 461-115-0020; 461-115-0230(5); 461-115-0540; 461-115-0610(1),(2),(3); 461-115-0700; 461-120-0315; 461-120-0330(1),(3); 461-120-0345; 461-120-0510(1),(4),(5),(6),(7); 461-125-0310; 461-125-0330; 461-125-0350; 461-125-0370; 461-135-0730; 461-135-0745; 461-135-0750; 461-135-0771; 461-135-0780; 461-135-0790; 461-135-0800; 461-135-0820; 461-135-0830; 461-155-0295; 461-160-0010(3),(4),(5); 461-160-0015(3),(4),(5); 461-160-0540; 461-160-0550; 461-160-0551; 461-160-0552; 461-170-0130; 461-180-0085

OAR 410-120-1210; 461-001-0000(3); 461-155-0250; 461-110-0210; 461-110-0310; 461-110-0410; 461-110-0530(2),(4); 461-115-0010(1),(2),(3); 461-115-0020; 461-115-0230(5); 461-115-0540; 461-115-0610(1),(2),(3); 461-115-0700; 461-120-0315; 461-120-0330(1),(3); 461-120-0345; 461-120-0510(1),(4),(5),(6),(7); 461-125-0310; 461-125-0330; 461-125-0350; 461-125-0370; 461-135-0730; 461-135-0745; 461-135-0750; 461-135-0771; 461-135-0780; 461-135-0790; 461-135-0800; 461-135-0820; 461-135-0830; 461-155-0290; 461-155-0295; 461-160-0010(3),(4),(5); 461-160-0015(3),(4),(5); 461-160-0540; 461-160-0550; 461-160-0551; 461-160-0552; 461-170-0130; 461-180-0085

9b. Closure of OSIPM (or OSIPM and QMB) for being over income, client is not eligible for any APD medical program, and client did not return 7210 (SDS 540)

Faa’iidooyinkaaga caafimaad waxay joogsan doonaan laga bilaabo insert closure effective date mm/dd/yy. Hada ka dib uma qalantid Barnaamijka Dakhliga Caafimaad ee Dheeraadka ah ee Oregon (OSIPM) sababta oo ah dakhligaaga cusub ee aad ka hesho insert income source ee dhan $insert monthly income wuxuu kaa dhigayaa in aad ka kor marto heerka dakhli ee la isku dheelitiray ee OSIPM. Dakhligaagu wuxuu sidoo kale kaa dhigayaa in aad ka kor marto heerka dakhli ee la isku dheelitiray ee loogu talagalay barnaamijka U qalmida ka Faa’iidaysiga Medicare (QMB) ee bixiya lacagaha qaybta kaaga soo aada Medicare (Medicare premiums), copay-ga iyo lacagaha caymiska laga jaro (deductibles). Laga bilaabo taariikhda dhaqangalka ee kor ku qoran, adiga ayaa mus’uul ka noqon doona lacagaha qaybta kaaga soo aada Medicare (Medicare premiums) ee ay Waaxdu bixinaysay. Uma qalantid barnaamijyada gargaarka caafimaad ee ay maamusho Dadka Waayeelka ah ee Naafada ah (APD). Si loogu qalmo Barnaamijka Dakhliga Caafimaad ee Dheeraadka ah ee Oregon (OSIPM), waa in ay da’daadu tahay 65 jir ama ka wayn tahay, aadan indho qabin, ama leedahay naafanimo buuxinaysa heerarka u yaala Social Security-ga ISLA MARKAANA leedahay u qalmid la aqbalay ama la dhowray ama aad ku siman tahay xadka u yaala dakhliga iyo ilaha. Si loogu qalmo Barnaamijyada Lacag Kaydsashada ee Medicare (QMB, SMB, SMF) waa in aad leedahay Medicare Part A isla markaana leedahay dakhli ku siman xadka u yaala barnaamijka la oggol yahay. Waa in aad sidoo kale buuxisaa dhammaan shuruudaha looga baahan yahay u qalmida waxyaalaha aan dhaqaalaha ku xirnayn oo aad dhammeystirtaa arjiga codsi iyo nidaamka caddeynta si aad aad ugu qalanto barnaamijyada caafimaad ee APD. Waxaa intaa dheer, taariikhdu markay ahayd insert date 7210 sent mm/dd/yy waxaanu codsanay in aad buuxiso oo aad soo celiso arjiga si uu kuu qiimeeyo Maamulka Caafimaadka Oregon kaasi oo loogu talagalay barnaamijyada kale ee Medicaid. Waxaan ku siinay ilaa insert 7210 due date mm/dd/yy si aad u dhammeystirto talaabadani. Ma aadan soo celin arjiga; sidaa darteed, Maamulka Caafimaadka Oregon go’aan kama gaari karo u qalmidaada barnaamijyada kale ee Medicaid.

Faa’iidooyinkaaga caafimaad waxay joogsan doonaan laga bilaabo insert closure effective date mm/dd/yy. Hada ka dib uma qalantid Barnaamijka Dakhliga Caafimaad ee Dheeraadka ah ee Oregon (OSIPM) sababta oo ah dakhligaaga cusub ee aad ka hesho insert income source ee dhan $insert monthly income wuxuu kaa dhigayaa in aad ka kor marto heerka dakhli ee la isku dheelitiray ee OSIPM. Uma qalantid barnaamijyada gargaarka caafimaad ee ay maamusho Dadka Waayeelka ah ee Naafada ah (APD). Si loogu qalmo Barnaamijka Dakhliga Caafimaad ee Dheeraadka ah ee Oregon (OSIPM), waa in ay da’daadu tahay 65 jir ama ka wayn tahay, aadan indho qabin, ama leedahay naafanimo buuxinaysa heerarka u yaala Social Security-ga ISLA MARKAANA leedahay u qalmid la aqbalay ama la dhowray ama aad ku siman tahay xadka u yaala dakhliga iyo ilaha. Si loogu qalmo Barnaamijyada Lacag Kaydsashada ee Medicare (QMB, SMB, SMF) waa in aad leedahay Medicare Part A isla markaana leedahay dakhli ku siman xadka u yaala barnaamijka la oggol yahay. Waa in aad sidoo kale buuxisaa dhammaan shuruudaha looga baahan yahay u qalmida waxyaalaha aan dhaqaalaha ku xirnayn oo aad dhammeystirtaa arjiga codsi iyo nidaamka caddeynta si aad aad ugu qalanto barnaamijyada caafimaad ee APD. Waxaa intaa dheer, taariikhdu markay ahayd insert date 7210 sent mm/dd/yy waxaanu codsanay in aad buuxiso oo aad soo celiso arjiga si uu kuu qiimeeyo Maamulka Caafimaadka Oregon kaasi oo loogu talagalay barnaamijyada kale ee Medicaid. Waxaan ku siinay ilaa insert 7210 due date mm/dd/yy si aad u dhammeystirto talaabadani. Ma aadan soo celin arjiga; sidaa darteed, Maamulka Caafimaadka Oregon go’aan kama gaari karo u qalmidaada barnaamijyada kale ee Medicaid.

OAR 410-120-1210; 461-001-0000(3); 461-155-0250; 461-110-0210; 461-110-0310; 461-110-0410; 461-110-0530(2),(4); 461-115-0010(1),(2),(3); 461-115-0020; 461-115-0230(5); 461-115-0540; 461-115-0610(1),(2),(3); 461-115-0700; 461-120-0315; 461-120-0330(1),(3); 461-120-0345; 461-120-0510(1),(4),(5),(6),(7); 461-125-0310; 461-125-0330; 461-125-0350; 461-125-0370; 461-135-0730; 461-135-0745; 461-135-0750; 461-135-0771; 461-135-0780; 461-135-0790; 461-135-0800; 461-135-0820; 461-135-0830; 461-155-0290; 461-155-0295; 461-160-0010(3),(4),(5); 461-160-0015(3),(4),(5); 461-160-0540; 461-160-0550; 461-160-0551; 461-160-0552; 461-170-0130; 461-180-0085

10a. Closure of OSIPM for no longer residing in an acute care hospital or nursing facility, client is over income, is not eligible for any APD medical program, 7210 was returned, and MAGI was denied (SDS 540)

Faa’iidooyinkaaga caafimaad waxay joogsan doonaan laga bilaabo insert closure effective date mm/dd/yy. Waxaad helaysay faa’iidooyinka Barnaamijka Dakhliga Dheeraadka ah ee Oregon-Caafimaadka (OSIPM) ee loogu talagalay dadka degan goob laga bixiyo daryeelka loogu talagalay xaaladda daran kaasi oo ah ugu yaraan 30 maalmood oo joogto ah. Sababta oo ah adiga oo aanan hada ka dib deganayn isbitaal laga bixiyo daryeelka xaaladda daran ama xarun dadka lagu xanaaneeyo isla markaana aan helayn adeegyada guriga iyo bulshada ku saleysan, dakhligaaga dhan $insert adjusted income wuxuu kaa dhigayaa in aad ka kor marto heerka dakhli ee la isku dheelitiray ee loogu talagalay OSIPM. Laga bilaabo taariikhda dhaqangalka ee kor ku qoran, adiga ayaa mus’uul ka noqon doona lacagaha qaybta kaaga soo aada Medicare (Medicare premiums) ee ay Waaxdu bixinaysay. Uma qalantid barnaamijyada gargaarka caafimaad ee ay maamusho Dadka Waayeelka ah ee Naafada ah (APD). Si loogu qalmo Barnaamijka Dakhliga Caafimaad ee Dheeraadka ah ee Oregon (OSIPM), waa in ay da’daadu tahay 65 jir ama ka wayn tahay, aadan indho qabin, ama leedahay naafanimo buuxinaysa heerarka u yaala Social Security-ga ISLA MARKAANA leedahay u qalmid la aqbalay ama la dhowray ama aad ku siman tahay xadka u yaala dakhliga iyo ilaha. Si loogu qalmo Barnaamijyada Lacag Kaydsashada ee Medicare (QMB, SMB, SMF) waa in aad leedahay Medicare Part A isla markaana leedahay dakhli ku siman xadka u yaala barnaamijka la oggol yahay. Waa in aad sidoo kale buuxisaa dhammaan shuruudaha looga baahan yahay u qalmida waxyaalaha aan dhaqaalaha ku xirnayn oo aad dhammeystirtaa arjiga codsi iyo nidaamka caddeynta si aad aad ugu qalanto barnaamijyada caafimaad ee APD. Waxaad heli doontaa ogeysiin gooni oo ku saabsan u barnaamijyada kale ee Medicaid ee uu bixiyo Maamulka Caafimaadka Oregon.

OAR 410-120-1210; 461-001-0000(3); 461-135-0745; 461-135-0750; 461-155-0250; 461-110-0210; 461-110-0310; 461-110-0410; 461-110-0530(2),(4); 461-115-0010(1),(2),(3); 461-115-0020; 461-115-0230(5); 461-115-0540; 461-115-0610(1),(2),(3); 461-115-0700; 461-120-0315; 461-120-0330(1),(3); 461-120-0345; 461-120-0510(1),(4),(5),(6),(7); 461-125-0310; 461-125-0330; 461-125-0350; 461-125-0370; 461-135-0730; 461-135-0771; 461-135-0780; 461-135-0790; 461-135-0800; 461-135-0820; 461-135-0830; 461-155-0290; 461-155-0295; 461-160-0010(3),(4),(5); 461-160-0015(3),(4),(5); 461-160-0540; 461-160-0550; 461-160-0551; 461-160-0552; 461-170-0130; 461-180-0085

Faa’iidooyinkaaga caafimaad waxay joogsan doonaan laga bilaabo insert closure effective date mm/dd/yy. Waxaad helaysay faa’iidooyinka Barnaamijka Dakhliga Dheeraadka ah ee Oregon-Caafimaadka (OSIPM) ee loogu talagalay dadka degan goob laga bixiyo daryeelka loogu talagalay xaaladda daran kaasi oo ah ugu yaraan 30 maalmood oo joogto ah. Sababta oo ah adiga oo aanan hada ka dib deganayn isbitaal laga bixiyo daryeelka xaaladda daran ama xarun dadka lagu xanaaneeyo isla markaana aan helayn adeegyada guriga iyo bulshada ku saleysan, dakhligaaga dhan $insert adjusted income wuxuu kaa dhigayaa in aad ka kor marto heerka dakhli ee la isku dheelitiray ee loogu talagalay OSIPM. Uma qalantid barnaamijyada gargaarka caafimaad ee ay maamusho Dadka Waayeelka ah ee Naafada ah (APD). Si loogu qalmo Barnaamijka Dakhliga Caafimaad ee Dheeraadka ah ee Oregon (OSIPM), waa in ay da’daadu tahay 65 jir ama ka wayn tahay, aadan indho qabin, ama leedahay naafanimo buuxinaysa heerarka u yaala Social Security-ga ISLA MARKAANA leedahay u qalmid la aqbalay ama la dhowray ama aad ku siman tahay xadka u yaala dakhliga iyo ilaha. Si loogu qalmo Barnaamijyada Lacag Kaydsashada ee Medicare (QMB, SMB, SMF) waa in aad leedahay Medicare Part A isla markaana leedahay dakhli ku siman xadka u yaala barnaamijka la oggol yahay. Waa in aad sidoo kale buuxisaa dhammaan shuruudaha looga baahan yahay u qalmida waxyaalaha aan dhaqaalaha ku xirnayn oo aad dhammeystirtaa arjiga codsi iyo nidaamka caddeynta si aad aad ugu qalanto barnaamijyada caafimaad ee APD. Waxaad heli doontaa ogeysiin gooni oo ku saabsan u barnaamijyada kale ee Medicaid ee uu bixiyo Maamulka Caafimaadka Oregon.

10b. Closure of OSIPM for no longer residing in an acute care hospital or nursing facility, client is over income, is not eligible for any APD medical program, and client did not return 7210 (SDS 540)

Faa’iidooyinkaaga caafimaad waxay joogsan doonaan laga bilaabo insert closure effective date mm/dd/yy. Waxaad helaysay faa’iidooyinka Barnaamijka Dakhliga Dheeraadka ah ee Oregon-Caafimaadka (OSIPM) ee loogu talagalay dadka degan goob laga bixiyo daryeelka loogu talagalay xaaladda daran kaasi oo ah ugu yaraan 30 maalmood oo joogto ah. Sababta oo ah adiga oo aanan hada ka dib deganayn isbitaal laga bixiyo daryeelka xaaladda daran ama xarun dadka lagu xanaaneeyo isla markaana aan helayn adeegyada guriga iyo bulshada ku saleysan, dakhligaaga dhan $insert adjusted income wuxuu kaa dhigayaa in aad ka kor marto heerka dakhli ee la isku dheelitiray ee loogu talagalay OSIPM. Laga bilaabo taariikhda dhaqangalka ee kor ku qoran, adiga ayaa mus’uul ka noqon doona lacagaha qaybta kaaga soo aada Medicare (Medicare premiums) ee ay Waaxdu bixinaysay. Uma qalantid barnaamijyada gargaarka caafimaad ee ay maamusho Dadka Waayeelka ah ee Naafada ah (APD). Si loogu qalmo Barnaamijka Dakhliga Caafimaad ee Dheeraadka ah ee Oregon (OSIPM), waa in ay da’daadu tahay 65 jir ama ka wayn tahay, aadan indho qabin, ama leedahay naafanimo buuxinaysa heerarka u yaala Social Security-ga ISLA MARKAANA leedahay u qalmid la aqbalay ama la dhowray ama aad ku siman tahay xadka u yaala dakhliga iyo ilaha. Si loogu qalmo Barnaamijyada Lacag Kaydsashada ee Medicare (QMB, SMB, SMF) waa in aad leedahay Medicare Part A isla markaana leedahay dakhli ku siman xadka u yaala barnaamijka la oggol yahay. Waa in aad sidoo kale buuxisaa dhammaan shuruudaha looga baahan yahay u qalmida waxyaalaha aan dhaqaalaha ku xirnayn oo aad dhammeystirtaa arjiga codsi iyo nidaamka caddeynta si aad aad ugu qalanto barnaamijyada caafimaad ee APD. Waxaa intaa dheer, taariikhdu markay ahayd insert date 7210 sent mm/dd/yy waxaanu codsanay in aad buuxiso oo aad soo celiso arjiga si uu kuu qiimeeyo Maamulka Caafimaadka Oregon kaasi oo loogu talagalay barnaamijyada kale ee Medicaid. Waxaan ku siinay ilaa insert 7210 due date mm/dd/yy si aad u dhammeystirto talaabadani. Ma aadan soo celin arjiga; sidaa darteed, Maamulka Caafimaadka Oregon go’aan kama gaari karo u qalmidaada barnaamijyada kale ee Medicaid.

OAR 410-120-1210; 461-001-0000(3); 461-135-0745; 461-135-0750; 461-155-0250; 461-110-0210; 461-110-0310; 461-110-0410; 461-110-0530(2),(4); 461-115-0010(1),(2),(3); 461-115-0020; 461-115-0230(5); 461-115-0540; 461-115-0610(1),(2),(3); 461-115-0700; 461-120-0315; 461-120-0330(1)(3); 461-120-0345; 461-120-0510(1),(4),(5),(6),(7); 461-125-0310; 461-125-0330; 461-125-0350; 461-125-0370; 461-135-0730; 461-135-0771; 461-135-0780; 461-135-0790; 461-135-0800; 461-135-0820; 461-135-0830; 461-155-0290; 461-155-0295; 461-160-0010(3),(4),(5); 461-160-0015(3),(4),(5); 461-160-0540; 461-160-0550; 461-160-0551; 461-160-0552; 461-170-0130; 461-180-0085

Faa’iidooyinkaaga caafimaad waxay joogsan doonaan laga bilaabo insert closure effective date mm/dd/yy. Waxaad helaysay faa’iidooyinka Barnaamijka Dakhliga Dheeraadka ah ee Oregon-Caafimaadka (OSIPM) ee loogu talagalay dadka degan goob laga bixiyo daryeelka loogu talagalay xaaladda daran kaasi oo ah ugu yaraan 30 maalmood oo joogto ah. Sababta oo ah adiga oo aanan hada ka dib deganayn isbitaal laga bixiyo daryeelka xaaladda daran ama xarun dadka lagu xanaaneeyo isla markaana aan helayn adeegyada guriga iyo bulshada ku saleysan, dakhligaaga dhan $insert adjusted income wuxuu kaa dhigayaa in aad ka kor marto heerka dakhli ee la isku dheelitiray ee loogu talagalay OSIPM. Uma qalantid barnaamijyada gargaarka caafimaad ee ay maamusho Dadka Waayeelka ah ee Naafada ah (APD). Si loogu qalmo Barnaamijka Dakhliga Caafimaad ee Dheeraadka ah ee Oregon (OSIPM), waa in ay da’daadu tahay 65 jir ama ka wayn tahay, aadan indho qabin, ama leedahay naafanimo buuxinaysa heerarka u yaala Social Security-ga ISLA MARKAANA leedahay u qalmid la aqbalay ama la dhowray ama aad ku siman tahay xadka u yaala dakhliga iyo ilaha. Si loogu qalmo Barnaamijyada Lacag Kaydsashada ee Medicare (QMB, SMB, SMF) waa in aad leedahay Medicare Part A isla markaana leedahay dakhli ku siman xadka u yaala barnaamijka la oggol yahay. Waa in aad sidoo kale buuxisaa dhammaan shuruudaha looga baahan yahay u qalmida waxyaalaha aan dhaqaalaha ku xirnayn oo aad dhammeystirtaa arjiga codsi iyo nidaamka caddeynta si aad aad ugu qalanto barnaamijyada caafimaad ee APD. Waxaa intaa dheer, taariikhdu markay ahayd insert date 7210 sent mm/dd/yy waxaanu codsanay in aad buuxiso oo aad soo celiso arjiga si uu kuu qiimeeyo Maamulka Caafimaadka Oregon kaasi oo loogu talagalay barnaamijyada kale ee Medicaid. Waxaan ku siinay ilaa insert 7210 due date mm/dd/yy si aad u dhammeystirto talaabadani. Ma aadan soo celin arjiga; sidaa darteed, Maamulka Caafimaadka Oregon go’aan kama gaari karo u qalmidaada barnaamijyada kale ee Medicaid.

OAR 410-120-1210; 461-001-0000(3); 461-135-0745; 461-135-0750; 461-155-0250; 461-110-0210; 461-110-0310; 461-110-0410; 461-110-0530(2),(4); 461-115-0010(1),(2),(3); 461-115-0020; 461-115-0230(5); 461-115-0540; 461-115-0610(1),(2),(3); 461-115-0700; 461-120-0315; 461-120-0330(1)(3); 461-120-0345; 461-120-0510(1),(4),(5),(6),(7); 461-125-0310; 461-125-0330; 461-125-0350; 461-125-0370; 461-135-0730; 461-135-0771; 461-135-0780; 461-135-0790; 461-135-0800; 461-135-0820; 461-135-0830; 461-155-0290; 461-155-0295; 461-160-0010(3),(4),(5); 461-160-0015(3),(4),(5); 461-160-0540; 461-160-0550; 461-160-0551; 461-160-0552; 461-170-0130; 461-180-0085

11a. Closure of SMB due to a change in income or yearly change in income standards, client is not eligible for any APD medical program, 7210 was returned and MAGI was denied (SDS 540)

Do not send notice and close medical until after 5503 determines eligibility for MAGI medical. If MAGI is approved, 5503 will close the APD medical case and no notice is necessary.

Dakhliga aad hada samayso wuxuu kaa dhigayaa in aad ka kor marto heerka dakhli ee la isku dheelitiray ee loogu talagalay Barnaamijkaaga Lacag Kaydsashada ee Medicare, Dakhliga Hoose ee la Tilmaamay ee Faa’iidaysiga Medicare (SMB) ee aad hada hesho ee bixiya lacagta qaybta kaaga soo aada Medicare Part B. Uma qalantid barnaamijyada gargaarka caafimaad ee ay maamusho Dadka Waayeelka ah ee Naafada ah (APD). Si loogu qalmo Barnaamijka Dakhliga Caafimaad ee Dheeraadka ah ee Oregon (OSIPM), waa in ay da’daadu tahay 65 jir ama ka wayn tahay, aadan indho qabin, ama leedahay naafanimo buuxinaysa heerarka u yaala Social Security-ga ISLA MARKAANA leedahay u qalmid la aqbalay ama la dhowray ama aad ku siman tahay xadka u yaala dakhliga iyo ilaha. Si loogu qalmo Barnaamijyada Lacag Kaydsashada ee Medicare (QMB, SMB, SMF) waa in aad leedahay Medicare Part A isla markaana leedahay dakhli ku siman xadka u yaala barnaamijka la oggol yahay. Waa in aad sidoo kale buuxisaa dhammaan shuruudaha looga baahan yahay u qalmida waxyaalaha aan dhaqaalaha ku xirnayn oo aad dhammeystirtaa arjiga codsi iyo nidaamka caddeynta si aad aad ugu qalanto barnaamijyada caafimaad ee APD. Waxaad heli doontaa ogeysiin gooni oo ku saabsan u barnaamijyada kale ee Medicaid ee uu bixiyo Maamulka Caafimaadka Oregon.

OAR 410-120-1210; 461-001-0000(3); 461-155-0295; 461-110-0210; 461-110-0310; 461-110-0410; 461-110-0530(2),(4); 461-115-0010(1),(2),(3); 461-115-0020; 461-115-0230(5); 461-115-0540; 461-115-0610(1),(2),(3); 461-115-0700; 461-120-0315; 461-120-0330(1),(3); 461-120-0345; 461-120-0510(1),(4),(5),(6),(7); 461-125-0310; 461-125-0330; 461-125-0350; 461-125-0370; 461-135-0730; 461-135-0745; 461-135-0750; 461-135-0771; 461-135-0780; 461-135-0790; 461-135-0800; 461-135-0820; 461-135-0830; 461-155-0250; 461-155-0290; 461-160-0010(3),(4),(5); 461-160-0015(3),(4),(5); 461-160-0540; 461-160-0550; 461-160-0551; 461-160-0552; 461-170-0130; 461-180-0085

11b. Closure of SMF due to a change in income or yearly change in income standards, client is not eligible for any APD medical program, 7210 was returned and MAGI was denied (SDS 540)

Do not send notice and close medical until after 5503 determines eligibility for MAGI medical. If MAGI is approved, 5503 will close the APD medical case and no notice is necessary.

Dakhliga aad hada samayso wuxuu kaa dhigayaa in aad ka kor marto heerka dakhli ee la isku dheelitiray ee loogu talagalay Barnaamijkaaga Lacag Kaydsashada ee Medicare, Barnaamijka Shakhsiyaadka U qalma (SMF) ee hada hesho ee bixiya lacagta qaybta kaaga soo aada Medicare Part B. Uma qalantid barnaamijyada gargaarka caafimaad ee ay maamusho Dadka Waayeelka ah ee Naafada ah (APD). Si loogu qalmo Barnaamijka Dakhliga Caafimaad ee Dheeraadka ah ee Oregon (OSIPM), waa in ay da’daadu tahay 65 jir ama ka wayn tahay, aadan indho qabin, ama leedahay naafanimo buuxinaysa heerarka u yaala Social Security-ga ISLA MARKAANA leedahay u qalmid la aqbalay ama la dhowray ama aad ku siman tahay xadka u yaala dakhliga iyo ilaha. Si loogu qalmo Barnaamijyada Lacag Kaydsashada ee Medicare (QMB, SMB, SMF) waa in aad leedahay Medicare Part A isla markaana leedahay dakhli ku siman xadka u yaala barnaamijka la oggol yahay. Waa in aad sidoo kale buuxisaa dhammaan shuruudaha looga baahan yahay u qalmida waxyaalaha aan dhaqaalaha ku xirnayn oo aad dhammeystirtaa arjiga codsi iyo nidaamka caddeynta si aad aad ugu qalanto barnaamijyada caafimaad ee APD. Waxaad heli doontaa ogeysiin gooni oo ku saabsan u barnaamijyada kale ee Medicaid ee uu bixiyo Maamulka Caafimaadka Oregon.

11c. Closure of SMB due to a change in income or yearly change in income standards, client is not eligible for any APD medical program, and client did not return 7210 - SMB-only clients (SDS 540)

Dakhliga aad hada samayso wuxuu kaa dhigayaa in aad ka kor marto heerka dakhli ee la isku dheelitiray ee loogu talagalay Barnaamijkaaga Lacag Kaydsashada ee Medicare, Dakhliga Hoose ee la Tilmaamay ee Faa’iidaysiga Medicare (SMB) ee aad hada hesho ee bixiya lacagta qaybta kaaga soo aada Medicare Part B. Uma qalantid barnaamijyada gargaarka caafimaad ee ay maamusho Dadka Waayeelka ah ee Naafada ah (APD). Si loogu qalmo Barnaamijka Dakhliga Caafimaad ee Dheeraadka ah ee Oregon (OSIPM), waa in ay da’daadu tahay 65 jir ama ka wayn tahay, aadan indho qabin, ama leedahay naafanimo buuxinaysa heerarka u yaala Social Security-ga ISLA MARKAANA leedahay u qalmid la aqbalay ama la dhowray ama aad ku siman tahay xadka u yaala dakhliga iyo ilaha. Si loogu qalmo Barnaamijyada Lacag Kaydsashada ee Medicare (QMB, SMB, SMF) waa in aad leedahay Medicare Part A isla markaana leedahay dakhli ku siman xadka u yaala barnaamijka la oggol yahay. Waa in aad sidoo kale buuxisaa dhammaan shuruudaha looga baahan yahay u qalmida waxyaalaha aan dhaqaalaha ku xirnayn oo aad dhammeystirtaa arjiga codsi iyo nidaamka caddeynta si aad aad ugu qalanto barnaamijyada caafimaad ee APD. Waxaa intaa dheer, taariikhdu markay ahayd insert date 7210 sent mm/dd/yy waxaanu codsanay in aad buuxiso oo aad soo celiso arjiga si uu kuu qiimeeyo Maamulka Caafimaadka Oregon kaasi oo loogu talagalay barnaamijyada kale ee Medicaid. Waxaan ku siinay ilaa insert 7210 due date mm/dd/yy si aad u dhammeystirto talaabadani. Ma aadan soo celin arjiga; sidaa darteed, Maamulka Caafimaadka Oregon go’aan kama gaari karo u qalmidaada barnaamijyada kale ee Medicaid.

11d. Closure of SMF due to a change in income or yearly change in income standards, client is not eligible for any APD medical program, and client did not return 7210 - SMF-only clients (SDS 540)

Dakhliga aad hada samayso wuxuu kaa dhigayaa in aad ka kor marto heerka dakhli ee la isku dheelitiray ee loogu talagalay Barnaamijkaaga Lacag Kaydsashada ee Medicare, Barnaamijka Shakhsiyaadka U qalma (SMF) ee aad hada hesho ee bixiya lacagta qaybta kaaga soo aada Medicare Part B. Uma qalantid barnaamijyada gargaarka caafimaad ee ay maamusho Dadka Waayeelka ah ee Naafada ah (APD). Si loogu qalmo Barnaamijka Dakhliga Caafimaad ee Dheeraadka ah ee Oregon (OSIPM), waa in ay da’daadu tahay 65 jir ama ka wayn tahay, aadan indho qabin, ama leedahay naafanimo buuxinaysa heerarka u yaala Social Security-ga ISLA MARKAANA leedahay u qalmid la aqbalay ama la dhowray ama aad ku siman tahay xadka u yaala dakhliga iyo ilaha. Si loogu qalmo Barnaamijyada Lacag Kaydsashada ee Medicare (QMB, SMB, SMF) waa in aad leedahay Medicare Part A isla markaana leedahay dakhli ku siman xadka u yaala barnaamijka la oggol yahay. Waa in aad sidoo kale buuxisaa dhammaan shuruudaha looga baahan yahay u qalmida waxyaalaha aan dhaqaalaha ku xirnayn oo aad dhammeystirtaa arjiga codsi iyo nidaamka caddeynta si aad aad ugu qalanto barnaamijyada caafimaad ee APD. Waxaa intaa dheer, taariikhdu markay ahayd insert date 7210 sent mm/dd/yy waxaanu codsanay in aad buuxiso oo aad soo celiso arjiga si uu kuu qiimeeyo Maamulka Caafimaadka Oregon kaasi oo loogu talagalay barnaamijyada kale ee Medicaid. Waxaan ku siinay ilaa insert 7210 due date mm/dd/yy si aad u dhammeystirto talaabadani. Ma aadan soo celin arjiga; sidaa darteed, Maamulka Caafimaadka Oregon go’aan kama gaari karo u qalmidaada barnaamijyada kale ee Medicaid.

12a. Closure of OSIPM-only for excess resources, client is not eligible for any APD medical program, 7210 was returned, and MAGI was denied (SDS 540)

Do not send notice and close medical until after 5503 determines eligibility for MAGI medical. If MAGI is approved, 5503 will close the OSIPM case and no notice is necessary.

Laga bilaabo insert closure effective date mm/dd/yy faa’iidooyinkaaga caafimaad waxay joogsan doonaan. Waxaad haysataa kheyraad ka badan xadka u yaala Barnaamijka Dakhliga Dheeraadka ah ee Oregon-Caafimaadka (OSIPM). Uma qalantid barnaamijyada gargaarka caafimaad ee ay maamusho Dadka Waayeelka ah ee Naafada ah (APD). Si loogu qalmo Barnaamijka Dakhliga Caafimaad ee Dheeraadka ah ee Oregon (OSIPM), waa in ay da’daadu tahay 65 jir ama ka wayn tahay, aadan indho qabin, ama leedahay naafanimo buuxinaysa heerarka u yaala Social Security-ga ISLA MARKAANA leedahay u qalmid la aqbalay ama la dhowray ama aad ku siman tahay xadka u yaala dakhliga iyo ilaha. Si loogu qalmo Barnaamijyada Lacag Kaydsashada ee Medicare (QMB, SMB, SMF) waa in aad leedahay Medicare Part A isla markaana leedahay dakhli ku siman xadka u yaala barnaamijka la oggol yahay. Waa in aad sidoo kale buuxisaa dhammaan shuruudaha looga baahan yahay u qalmida waxyaalaha aan dhaqaalaha ku xirnayn oo aad dhammeystirtaa arjiga codsi iyo nidaamka caddeynta si aad aad ugu qalanto barnaamijyada caafimaad ee APD. Waxaad heli doontaa ogeysiin gooni oo ku saabsan u barnaamijyada kale ee Medicaid ee uu bixiyo Maamulka Caafimaadka Oregon.

OAR 410-120-1210; 461-160-0010(3); 461-160-0015(3); 461-110-0210; 461-110-0310; 461-110-0410; 461-110-0530(2),(4); 461-115-0010(1),(2),(3); 461-115-0020; 461-115-0230(5); 461-115-0540; 461-115-0610(1),(2),(3); 461-115-0700; 461-120-0315; 461-120-0330(1),(3); 461-120-0345; 461-120-0510(1),(4),(5),(6),(7); 461-125-0310; 461-125-0330; 461-125-0350; 461-125-0370; 461-135-0730; 461-135-0745; 461-135-0750; 461-135-0771; 461-135-0780; 461-135-0790; 461-135-0800; 461-135-0820; 461-135-0830; 461-155-0250; 461-155-0290; 461-155-0295; 461-160-0010(3),(4),(5); 461-160-0015(3),(4),(5); 461-160-0540; 461-160-0550; 461-160-0551; 461-160-0552; 461-170-0130; 461-180-0085

12b. Closure of OSIPM-only for excess resources, client is not eligible for any APD medical program, and client did not return 7210(SDS 540)

Laga bilaabo insert closure effective date mm/dd/yy faa’iidooyinkaaga caafimaad waxay joogsan doonaan. Waxaad haysataa kheyraad ka badan xadka u yaala Barnaamijka Dakhliga Dheeraadka ah ee Oregon-Caafimaadka (OSIPM). Uma qalantid barnaamijyada gargaarka caafimaad ee ay maamusho Dadka Waayeelka ah ee Naafada ah (APD). Si loogu qalmo Barnaamijka Dakhliga Caafimaad ee Dheeraadka ah ee Oregon (OSIPM), waa in ay da’daadu tahay 65 jir ama ka wayn tahay, aadan indho qabin, ama leedahay naafanimo buuxinaysa heerarka u yaala Social Security-ga ISLA MARKAANA leedahay u qalmid la aqbalay ama la dhowray ama aad ku siman tahay xadka u yaala dakhliga iyo ilaha. Si loogu qalmo Barnaamijyada Lacag Kaydsashada ee Medicare (QMB, SMB, SMF) waa in aad leedahay Medicare Part A isla markaana leedahay dakhli ku siman xadka u yaala barnaamijka la oggol yahay. Waa in aad sidoo kale buuxisaa dhammaan shuruudaha looga baahan yahay u qalmida waxyaalaha aan dhaqaalaha ku xirnayn oo aad dhammeystirtaa arjiga codsi iyo nidaamka caddeynta si aad aad ugu qalanto barnaamijyada caafimaad ee APD. Waxaa intaa dheer, taariikhdu markay ahayd insert date 7210 sent mm/dd/yy waxaanu codsanay in aad buuxiso oo aad soo celiso arjiga si uu kuu qiimeeyo Maamulka Caafimaadka Oregon kaasi oo loogu talagalay barnaamijyada kale ee Medicaid. Waxaan ku siinay ilaa insert 7210 due date mm/dd/yy si aad u dhammeystirto talaabadani. Ma aadan soo celin arjiga; sidaa darteed, Maamulka Caafimaadka Oregon go’aan kama gaari karo u qalmidaada barnaamijyada kale ee Medicaid.

13. Inmate of an institution - no referral to 5503 needed

Si aad u hesho faa’iidooyinka caafimaad ma noqon kartid maxbuus ku jira goob dowladdu maamusho. Waxaa laguu tixgelinayaa in aad tahay maxbuus ku jira goob dowladdu maamusho. Uma qalantid wax barnaamij kale oo ay Medicaid leedahay. OAR 410-120-1210; 410-200-0140(1); 461-135-0950(1),(2),(3),(4),(5),(6),(7)

If OSIPM and/or QMB-BAS, add:

14. Disqualifying transfer of resources

Send the SDS 0540T for services and an SDS 540 for medical if the applicant is ineligible for all medical programs. Use notice language appropriate for the applicant’s scenario (e.g. over income). Otherwise reduce to appropriate program. Send SDS 0544 if appropriate (see the OSIP WG-7)

Medical Reduction

1a. Reduction of OSIPM to QMB benefits due to an increase in income, not potentially MAGI-eligible (SDS 540)

Dakhligaaga la isku dheelitiray ee hadu wuxuu kaa dhigayaa in aad ka kor marto dakhliga loogu talagalay Barnaamijka Dakhliga Dheeraadka ah ee Oregon-Caafimaadka (OSIPM). Barnaamijka kaliya ee aad u qalantid waa barnaamijka U qalmida ka Faa’iidaysiga Medicare (QMB) ee bixiya lacagaha qaybta kaaga soo aada Medicare (Medicare premiums), qaar ka mid ah copay-ga & lacagaha caymiska laga jaro (deductibles). Uma qalantid barnaamijyada MAGI Medicaid sababta oo ah uur ma lihid, iyada oo ay da’daadu ka weyn tahay 18 jir ama ka weyn tahay 64 jir haystana Medicare iyo adiga oo aan ahayn waalid iyo qaraabo xanaanaynaysa ilme kugu tiirsan oo kula nool.

OAR 410-120-1210, 410-200-0415(2); 410-200-0420(3); 410-200-0425(2); 410-200-0435(4); 461-001-0000(3); 461-155-0250; 461-155-0290; 461-160-0540; 461-110-0210; 461-110-0310; 461-110-0410; 461-110-0530(2),(4); 461-160-0550; 461-160-0551; 461-160-0552; 461-170-0130, 461-180-0085

1b. Reduction of OSIPM to QMB benefits due to an increase in income, potentially MAGI-eligible, 7210 was returned and MAGI was denied (SDS 540)

Do not send notice and reduce medical until after 5503 determines eligibility for MAGI medical. If MAGI is approved, 5503 will take the appropriate case actions and no notice is necessary.

Dakhligaaga la isku dheelitiray ee hadu wuxuu kaa dhigayaa in aad ka kor marto dakhliga loogu talagalay Barnaamijka Dakhliga Dheeraadka ah ee Oregon-Caafimaadka (OSIPM). Barnaamijka kaliya ee aad u qalantid waa barnaamijka U qalmida ka Faa’iidaysiga Medicare (QMB) ee bixiya lacagaha qaybta kaaga soo aada Medicare (Medicare premiums), qaar ka mid ah copay-ga & lacagaha caymiska laga jaro (deductibles). Taariikhdu markay ahayd insert date 7210 sent mm/dd/yy waxaanu codsanay in aad buuxiso oo aad soo celiso arjiga si uu kuu qiimeeyo Maamulka Caafimaadka Oregon kaasi oo loogu talagalay barnaamijyada kale ee Medicaid. Waxaad heli doontaa ogeysiin gooni oo ku saabsan u qalmidaada barnaamijyada kale ee Medicaid ee uu bixiyo Maamulka Caafimaadka Oregon.

OAR 410-120-1210; 461-001-0000(3); 461-155-0250; 461-155-0290; 461-160-0540; 461-110-0210; 461-110-0310; 461-110-0410; 461-110-0530(2),(4); 461-160-0550; 461-160-0551; 461-160-0552; 461-170-0130; 461-180-0085

1c. Reduction of OSIPM to QMB benefits due to an increase in income, potentially MAGI-eligible, and client did not return 7210 (SDS 540)

Dakhligaaga la isku dheelitiray ee hadu wuxuu kaa dhigayaa in aad ka kor marto dakhliga loogu talagalay Barnaamijka Dakhliga Dheeraadka ah ee Oregon-Caafimaadka (OSIPM). Barnaamijka kaliya ee aad u qalantid waa barnaamijka U qalmida ka Faa’iidaysiga Medicare (QMB) ee bixiya lacagaha qaybta kaaga soo aada Medicare (Medicare premiums), qaar ka mid ah copay-ga & lacagaha caymiska laga jaro (deductibles). Taariikhdu markay ahayd insert date 7210 sent mm/dd/yy waxaanu codsanay in aad buuxiso oo aad soo celiso arjiga si uu kuu qiimeeyo Maamulka Caafimaadka Oregon kaasi oo loogu talagalay barnaamijyada kale ee Medicaid. Waxaan ku siinay ilaa insert 7210 due date mm/dd/yy si aad u dhammeystirto talaabadani. Ma aadan soo celin arjiga; sidaa darteed, Maamulka Caafimaadka Oregon go’aan kama gaari karo u qalmidaada barnaamijyada kale ee Medicaid.

2a. Reduction of OSIPM to QMB benefits due to an increase in countable resources, not potentially MAGI-eligible (SDS 540)

Waxaad haysataa kheyraad ka badan xadka u yaala Barnaamijka Dakhliga Dheeraadka ah ee Oregon-Caafimaadka (OSIPM). Barnaamijka kaliya ee aad u qalantid waa barnaamijka U qalmida ka Faa’iidaysiga Medicare (QMB) ee bixiya lacagaha qaybta kaaga soo aada Medicare (Medicare premiums), qaar ka mid ah copay-ga & lacagaha caymiska laga jaro (deductibles). Uma qalantid barnaamijyada MAGI Medicaid sababta oo ah uur ma lihid, iyada oo ay da’daadu ka weyn tahay 18 jir ama ka weyn tahay 64 jir haystana Medicare iyo adiga oo aan ahayn waalid iyo qaraabo xanaanaynaysa ilme kugu tiirsan oo kula nool.
OAR 410-120-1210; 410-200-0415(2); 410-200-0420(3); 410-200-0425(2); 410-200-0435(4); 461-155-0290; 461-160-0015(3),(4); 461-110-0210; 461-110-0310; 461-110-0410; 461-110-0530(2),(4); 461-170-0130; 461-180-0085

2b. Reduction of OSIPM to QMB benefits due to an increase in countable resources, potentially MAGI-eligible, client returned 7210 and MAGI was denied (SDS 540)

Do not send notice and reduce medical until after 5503 determines eligibility for MAGI medical. If MAGI is approved, 5503 will take the appropriate case actions and no notice is necessary.

OAR 410-120-1210; 461-155-0290; 461-160-0015(3),(4); 461-110-0210; 461-110-0310; 461-110-0410; 461-110-0530(2),(4); 461-170-0130; 461-180-0085

2c. Reduction of OSIPM to QMB benefits due to an increase in countable resources, potentially MAGI-eligible, client did not return 7210 (SDS 540)

Waxaad haysataa kheyraad ka badan xadka u yaala Barnaamijka Dakhliga Dheeraadka ah ee Oregon-Caafimaadka (OSIPM). Barnaamijka kaliya ee aad u qalantid waa barnaamijka U qalmida ka Faa’iidaysiga Medicare (QMB) ee bixiya lacagaha qaybta kaaga soo aada Medicare (Medicare premiums), qaar ka mid ah copay-ga & lacagaha caymiska laga jaro (deductibles). Taariikhdu markay ahayd insert date 7210 sent mm/dd/yy waxaanu codsanay in aad buuxiso oo aad soo celiso arjiga si uu kuu qiimeeyo Maamulka Caafimaadka Oregon kaasi oo loogu talagalay barnaamijyada kale ee Medicaid. Waxaan ku siinay ilaa insert 7210 due date mm/dd/yy si aad u dhammeystirto talaabadani. Ma aadan soo celin arjiga; sidaa darteed, Maamulka Caafimaadka Oregon go’aan kama gaari karo u qalmidaada barnaamijyada kale ee Medicaid.

OAR 410-120-1210; 461-155-0290; 461-160-0015(3),(4); 461-110-0210; 461-110-0310; 461-110-0410; 461-110-0530(2),(4); 461-170-0130; 461-180-0085

3a. Reduction of OSIPM to SMB due to increased income or change in income, not potentially MAGI-eligible (SDS 540)

Dakhligaaga la isku dheelitiray ee hadu wuxuu kaa dhigayaa in aad ka kor marto dakhliga loogu talagalay Barnaamijka Dakhliga Dheeraadka ah ee Oregon-Caafimaadka (OSIPM). Barnaamijka kaliya ee aad u qalantid waa Barnaamijka Lacag Kaydsashada ee Medicare ee bixiya lacagta qaybta kaaga soo aada Medicare Part B, barnaamijka Dakhliga Hoose ee la Tilmaamay ee Faa’iidaysiga Medicare (SMB). Uma qalantid barnaamijyada MAGI Medicaid sababta oo ah uur ma lihid, iyada oo ay da’daadu ka weyn tahay 18 jir ama ka weyn tahay 64 jir haystana Medicare iyo adiga oo aan ahayn waalid iyo qaraabo xanaanaynaysa ilme kugu tiirsan oo kula nool.
OAR 410-120-1210; 410-200-0415(2); 410-200-0420(3); 410-200-0425(2); 410-200-0435(4); 461-001-0000(3); 461-155-0250; 461-155-0290; 461-155-0295(1); 461-160-0540; 461-110-0210; 461-110-0310; 461-110-0410; 461-110-0530(2),(4); 461-160-0550; 461-160-0551; 461-160-0552; 461-170-0130; 461-180-0085

For informational purposes ONLY: Because you were receiving Medicaid benefits which supplemented your Medicare, and the Medicaid benefits are ending, you have what is called “Guaranteed Issue” (GI) rights. This means you have 63 days following the date your benefits end to enroll in a Medigap Supplement plan. Please contact the Senior Health Insurance Benefits Assistance Program (SHIBA) at 1-800-722-4134 for more information. Oregon Administrative Rule 836-052-0142(2)(a) establishes who is eligible for the Guaranteed Issue rights.

3b. Reduction of OSIPM to SMF due to increased income or change in income, not potentially MAGI-eligible (SDS 540)

Dakhligaaga la isku dheelitiray ee hadu wuxuu kaa dhigayaa in aad ka kor marto dakhliga loogu talagalay Barnaamijka Dakhliga Dheeraadka ah ee Oregon-Caafimaadka (OSIPM). Barnaamijka kaliya ee aad u qalantid waa Barnaamijka Lacag Kaydsashada ee Medicare ee bixiya lacagta qaybta kaaga soo aada Medicare Part B, barnaamijka Shakhsiyaadka U qalma (SMF). Uma qalantid barnaamijyada MAGI Medicaid sababta oo ah uur ma lihid, iyada oo ay da’daadu ka weyn tahay 18 jir ama ka weyn tahay 64 jir haystana Medicare iyo adiga oo aan ahayn waalid iyo qaraabo xanaanaynaysa ilme kugu tiirsan oo kula nool.
OAR 410-120-1210, 410-200-0415(2); 410-200-0420(3); 410-200-0425(2); 410-200-0435(4); 461-001-0000(3); 461-155-0250; 461-155-0290; 461-155-0295(2); 461-160-0540; 461-110-0210; 461-110-0310; 461-110-0410; 461-110-0530(2),(4); 461-160-0550; 461-160-0551; 461-160-0552; 461-170-0130; 461-180-0085

3c. Reduction of OSIPM to SMB due to increased income or change in income, potentially MAGI-eligible, 7210 was returned, and MAGI was denied(SDS 540)

Do not send notice and reduce medical until after 5503 determines eligibility for MAGI medical. If MAGI is approved, 5503 will take the appropriate case actions and no notice is necessary.

OAR 410-120-1210, 461-001-0000(3); 461-155-0250; 461-155-0290; 461-155-0295(1); 461-160-0540; 461-110-0210; 461-110-0310; 461-110-0410; 461-110-0530(2),(4); 461-160-0550; 461-160-0551; 461-160-0552; 461-170-0130; 461-180-0085

3d. Reduction of OSIPM to SMF due to increased income or change in income, potentially MAGI-eligible, 7210 was returned, and MAGI was denied (SDS 540)

Do not send notice and reduce medical until after 5503 determines eligibility for MAGI medical. If MAGI is approved, 5503 will take the appropriate case actions and no notice is necessary.

OAR 410-120-1210; 461-001-0000(3); 461-155-0250; 461-155-0290; 461-155-0295(2); 461-160-0540; 461-110-0210; 461-110-0310; 461-110-0410; 461-110-0530(2),(4); 461-160-0550; 461-160-0551; 461-160-0552; 461-170-0130; 461-180-0085

3e. Reduction of OSIPM to SMB due to increased income or change in income, potentially MAGI-eligible, and client did not return 7210 (SDS 540)

Dakhligaaga la isku dheelitiray ee hadu wuxuu kaa dhigayaa in aad ka kor marto dakhliga loogu talagalay Barnaamijka Dakhliga Dheeraadka ah ee Oregon-Caafimaadka (OSIPM). Barnaamijka kaliya ee aad u qalantid waa Barnaamijka Lacag Kaydsashada ee Medicare ee bixiya lacagta qaybta kaaga soo aada Medicare Part B, barnaamijka Dakhliga Hoose ee la Tilmaamay ee Faa’iidaysiga Medicare (SMB). Taariikhdu markay ahayd insert date 7210 sent mm/dd/yy waxaanu codsanay in aad buuxiso oo aad soo celiso arjiga si uu kuu qiimeeyo Maamulka Caafimaadka Oregon kaasi oo loogu talagalay barnaamijyada kale ee Medicaid. Waxaan ku siinay ilaa insert 7210 due date mm/dd/yy si aad u dhammeystirto talaabadani. Ma aadan soo celin arjiga; sidaa darteed, Maamulka Caafimaadka Oregon go’aan kama gaari karo u qalmidaada barnaamijyada kale ee Medicaid.

OAR 410-120-1210; 461-001-0000(3); 461-155-0250; 461-155-0290; 461-155-0295(1); 461-160-0540; 461-110-0210; 461-110-0310; 461-110-0410; 461-110-0530(2),(4); 461-160-0550; 461-160-0551; 461-160-0552; 461-170-0130; 461-180-0085

3f. Reduction of OSIPM to SMF due to increased income or change in income, potentially MAGI-eligible, and client did not return 7210 (SDS 540)

Dakhligaaga la isku dheelitiray ee hadu wuxuu kaa dhigayaa in aad ka kor marto dakhliga loogu talagalay Barnaamijka Dakhliga Dheeraadka ah ee Oregon-Caafimaadka (OSIPM). Barnaamijka kaliya ee aad u qalantid waa Barnaamijka Lacag Kaydsashada ee Medicare ee bixiya lacagta qaybta kaaga soo aada Medicare Part B, barnaamijka Shakhsiyaadka U qalma (SMF). Taariikhdu markay ahayd insert date 7210 sent mm/dd/yy waxaanu codsanay in aad buuxiso oo aad soo celiso arjiga si uu kuu qiimeeyo Maamulka Caafimaadka Oregon kaasi oo loogu talagalay barnaamijyada kale ee Medicaid. Waxaan ku siinay ilaa insert 7210 due date mm/dd/yy si aad u dhammeystirto talaabadani. Ma aadan soo celin arjiga; sidaa darteed, Maamulka Caafimaadka Oregon go’aan kama gaari karo u qalmidaada barnaamijyada kale ee Medicaid.

4a. Reduction of OSIPM to SMB due to increase in countable resources, not potentially MAGI-eligible (SDS 540)

Waxaad haysataa kheyraad ka badan xadka u yaala Barnaamijka Dakhliga Dheeraadka ah ee Oregon-Caafimaadka (OSIPM). Barnaamijka kaliya ee aad u qalantid waa Barnaamijka Lacag Kaydsashada ee Medicare ee bixiya lacagta qaybta kaaga soo aada Medicare Part B, barnaamijka Dakhliga Hoose ee la Tilmaamay ee Faa’iidaysiga Medicare (SMB). Uma qalantid barnaamijyada MAGI Medicaid sababta oo ah uur ma lihid, iyada oo ay da’daadu ka weyn tahay 18 jir ama ka weyn tahay 64 jir haystana Medicare iyo adiga oo aan ahayn waalid iyo qaraabo xanaanaynaysa ilme kugu tiirsan oo kula nool.

OAR 410-120-1210; 410-200-0415(2); 410-200-0420(3); 410-200-0425(2); 410-200-0435(4); 461-155-0290; 461-155-0295(1); 461-160-0015(3),(4); 461-110-0210; 461-110-0310; 461-110-0410; 461-110-0530(2),(4); 461-170-0130; 461-180-0085

4b. Reduction of OSIPM to SMF due to increase in countable resources, not potentially MAGI-eligible (SDS 540)

OAR 410-120-1210; 410-200-0415(2); 410-200-0420(3); 410-200-0425(2); 410-200-0435(4); 461-155-0290; 461-155-0295(2); 461-160-0015(3),(4); 461-110-0210; 461-110-0310; 461-110-0410; 461-110-0530(2),(4); 461-170-0130; 461-180-0085

4c. Reduction of OSIPM to SMB due to increase in countable resources, potentially MAGI-eligible, 7210 was returned, and MAGI was denied (SDS 540)

Do not send notice and reduce medical until after 5503 determines eligibility for MAGI medical. If MAGI is approved, 5503 will take the appropriate case actions and no notice is necessary.

OAR 410-120-1210; 461-155-0290; 461-155-0295(1); 461-160-0015(3),(4); 461-110-0210; 461-110-0310; 461-110-0410; 461-110-0530(2),(4); 461-170-0130; 461-180-0085

4d. Reduction of OSIPM to SMF due to increase in countable resources, potentially MAGI-eligible, 7210 was returned, and MAGI was denied (SDS 540)

Do not send notice and reduce medical until after 5503 determines eligibility for MAGI medical. If MAGI is approved, 5503 will take the appropriate case actions and no notice is necessary.

OAR 410-120-1210; 461-155-0290; 461-155-0295(2); 461-160-0015(3),(4); 461-110-0210; 461-110-0310; 461-110-0410; 461-110-0530(2),(4); 461-170-0130; 461-180-0085

4e. Reduction of OSIPM to SMB due to increase in countable resources, potentially MAGI-eligible, and client did not return 7210 (SDS 540)

Waxaad haysataa kheyraad ka badan xadka u yaala Barnaamijka Dakhliga Dheeraadka ah ee Oregon-Caafimaadka (OSIPM). Barnaamijka kaliya ee aad u qalantid waa Barnaamijka Lacag Kaydsashada ee Medicare ee bixiya lacagta qaybta kaaga soo aada Medicare Part B, barnaamijka Dakhliga Hoose ee la Tilmaamay ee Faa’iidaysiga Medicare (SMB). Taariikhdu markay ahayd insert date 7210 sent mm/dd/yy waxaanu codsanay in aad buuxiso oo aad soo celiso arjiga si uu kuu qiimeeyo Maamulka Caafimaadka Oregon kaasi oo loogu talagalay barnaamijyada kale ee Medicaid. Waxaan ku siinay ilaa insert 7210 due date mm/dd/yy si aad u dhammeystirto talaabadani. Ma aadan soo celin arjiga; sidaa darteed, Maamulka Caafimaadka Oregon go’aan kama gaari karo u qalmidaada barnaamijyada kale ee Medicaid.

OAR 410-120-1210; 461-155-0290; 461-155-0295(1); 461-160-0015(3),(4); 461-110-0210; 461-110-0310;461-110-0410; 461-110-0530(2),(4); 461-170-0130; 461-180-0085

4f. Reduction of OSIPM to SMF due to increase in countable resources, potentially MAGI-eligible, and client did not return 7210 (SDS 540)

Waxaad haysataa kheyraad ka badan xadka u yaala Barnaamijka Dakhliga Dheeraadka ah ee Oregon-Caafimaadka (OSIPM). Barnaamijka kaliya ee aad u qalantid waa Barnaamijka Lacag Kaydsashada ee Medicare ee bixiya lacagta qaybta kaaga soo aada Medicare Part B, barnaamijka Shakhsiyaadka U qalma (SMF). Taariikhdu markay ahayd insert date 7210 sent mm/dd/yy waxaanu codsanay in aad buuxiso oo aad soo celiso arjiga si uu kuu qiimeeyo Maamulka Caafimaadka Oregon kaasi oo loogu talagalay barnaamijyada kale ee Medicaid. Waxaan ku siinay ilaa insert 7210 due date mm/dd/yy si aad u dhammeystirto talaabadani. Ma aadan soo celin arjiga; sidaa darteed, Maamulka Caafimaadka Oregon go’aan kama gaari karo u qalmidaada barnaamijyada kale ee Medicaid.

OAR 410-120-1210, 461-155-0290, 461-155-0295(2), 461-160-0015(3),(4), 461-110-0210, 461-110-0310, 461-110-0410, 461-110-0530(2),(4); 461-170-0130, 461-180-0085

5a. Reduction of OSIPM to QMB due to failure to provide verification of resources, potentially MAGI-eligible, and client did not return 7210 (SDS 540)

Translation not yet available. To request translation of the English sample language complete DHS 1001 and send to DHS-OHA.PublicationRequest@state.or.us and CC Rebecca Arce at rebecca.e.arce@dhsoha.state.or.us.

5b. Reduction of OSIPM to QMB due to failure to provide verification of resources, not potentially MAGI-eligible (SDS 540)

6a. Reduction of OSIPM to SMB or SMF due to failure to provide verification of resources, potentially MAGI-eligible, and client did not return 7210 (SDS 540)

6b. Reduction of OSIPM to SMB or SMF ailure to provide verification of resources, not potentially MAGI-eligible(SDS 540)

7a. Reduction of QMB-only to SMB due to a change in income or annual income standard change, not potentially MAGI-eligible (SDS 540)

Dakhligaaga la isku dheelitiray ee hadu wuxuu kaa dhigayaa in aad ka kor marto dakhliga loogu talagalay Barnaamijkaaga Lacag Kaydsashada ee Medicare, U qalmida ka Faa’iidaysiga Medicare (QMB) ee aad hada hesho ee bixiya lacagaha qaybta kaaga soo aada Medicare (Medicare premiums), lacagaha caymiska laga jaro (deductibles), iyo qaar ka mid ah copay-ga. Barnaamijka kaliya ee aad u qalantid waa barnaamijka Dakhliga Hoose ee la Tilmaamay ee Faa’iidaysiga Medicare (SMB) ee bixiya lacagta qaybta kaaga soo aada Medicare Part B (SMB ma bixiso lacagaha co-pay-ga ama lacagaha caymiska laga jaro ‘deductibles’). Uma qalantid barnaamijyada MAGI Medicaid sababta oo ah uur ma lihid, iyada oo ay da’daadu ka weyn tahay 18 jir ama ka weyn tahay 64 jir haystana Medicare iyo adiga oo aan ahayn waalid iyo qaraabo xanaanaynaysa ilme kugu tiirsan oo kula nool.

OAR 410-120-1210, 410-200-0415(2), 410-200-0420(3), 410-200-0425(2), 410-200-0435(4), 461-001-0000(3), 461-110-0210, 461-110-0310, 461-110-0410, 461-110-0530(2), 461-155-0290, 461-155-0295(1), 461-160-0540, 461-160-0552, 461-170-0130, 461-180-0085

7b. Reduction of QMB-only to SMF due to a change in income or annual income standard change, not potentially MAGI-eligible (SDS 540)

Dakhligaaga la isku dheelitiray ee hadu wuxuu kaa dhigayaa in aad ka kor marto dakhliga loogu talagalay Barnaamijkaaga Lacag Kaydsashada ee Medicare, U qalmida ka Faa’iidaysiga Medicare (QMB) ee aad hada hesho ee bixiya lacagaha qaybta kaaga soo aada Medicare (Medicare premiums), lacagaha caymiska laga jaro (deductibles), iyo qaar ka mid ah copay-ga. Barnaamijka kaliya ee aad u qalantid waa barnaamijka Shakhsiyaadka U qalma (SMF) ee bixiya lacagta qaybta kaaga soo aada Medicare Part B (SMF ma bixiso lacagaha co-pay-ga ama lacagaha caymiska laga jaro ‘deductibles’). Uma qalantid barnaamijyada MAGI Medicaid sababta oo ah uur ma lihid, iyada oo ay da’daadu ka weyn tahay 18 jir ama ka weyn tahay 64 jir haystana Medicare iyo adiga oo aan ahayn waalid iyo qaraabo xanaanaynaysa ilme kugu tiirsan oo kula nool.

OAR 410-120-1210, 410-200-0415(2), 410-200-0420(3), 410-200-0425(2), 410-200-0435(4), 461-001-0000(3), 461-110-0210, 461-110-0310, 461-110-0410, 461-110-0530(2), 461-155-0290, 461-155-0295(2), 461-160-0540, 461-160-0552, 461-170-0130, 461-180-0085

7c. Reduction of QMB-only to SMB due to a change in income or annual income standard change, potentially MAGI-eligible, 7210 was returned, and MAGI was denied(SDS 540)

Do not send notice and reduce medical until after 5503 determines eligibility for MAGI medical. If MAGI is approved, 5503 will take the necessary case actions and no notice is necessary.

Dakhligaaga la isku dheelitiray ee hadu wuxuu kaa dhigayaa in aad ka kor marto dakhliga loogu talagalay Barnaamijkaaga Lacag Kaydsashada ee Medicare, U qalmida ka Faa’iidaysiga Medicare (QMB) ee aad hada hesho ee bixiya lacagaha qaybta kaaga soo aada Medicare (Medicare premiums), lacagaha caymiska laga jaro (deductibles), iyo qaar ka mid ah copay-ga. Barnaamijka kaliya ee aad u qalantid waa barnaamijka Dakhliga Hoose ee la Tilmaamay ee Faa’iidaysiga Medicare (SMB) ee bixiya lacagta qaybta kaaga soo aada Medicare Part B (SMB ma bixiso lacagaha co-pay-ga ama lacagaha caymiska laga jaro ‘deductibles’). Waxaad heli doontaa ogeysiin gooni oo ku saabsan u qalmidaada barnaamijyada kale ee Medicaid ee uu bixiyo Maamulka Caafimaadka Oregon.

OAR 410-120-1210, 461-001-0000(3), 461-110-0210, 461-110-0310, 461-110-0410, 461-110-0530(2), 461-155-0290, 461-155-0295(1), 461-160-0540, 461-160-0552, 461-170-0130, 461-180-0085

7d. Reduction of QMB-only to SMF due to a change in income or annual income standard change, potentially MAGI-eligible, 7210 was returned, and MAGI was denied (SDS 540)

Do not send notice and reduce medical until after 5503 determines eligibility for MAGI medical. If MAGI is approved, 5503 will take the necessary case actions and no notice is necessary.

Dakhligaaga la isku dheelitiray ee hadu wuxuu kaa dhigayaa in aad ka kor marto dakhliga loogu talagalay Barnaamijkaaga Lacag Kaydsashada ee Medicare, U qalmida ka Faa’iidaysiga Medicare (QMB) ee aad hada hesho ee bixiya lacagaha qaybta kaaga soo aada Medicare (Medicare premiums), lacagaha caymiska laga jaro (deductibles), iyo qaar ka mid ah copay-ga. Barnaamijka kaliya ee aad u qalantid waa barnaamijka Shakhsiyaadka U qalma (SMF) ee bixiya lacagta qaybta kaaga soo aada Medicare Part B (SMF ma bixiso lacagaha co-pay-ga ama lacagaha caymiska laga jaro ‘deductibles’). Waxaad heli doontaa ogeysiin gooni oo ku saabsan u qalmidaada barnaamijyada kale ee Medicaid ee uu bixiyo Maamulka Caafimaadka Oregon.

OAR 410-120-1210, 461-001-0000(3), 461-110-0210, 461-110-0310, 461-110-0410, 461-110-0530(2), 461-155-0290, 461-155-0295(2), 461-160-0540, 461-160-0552, 461-170-0130, 461-180-0085

7e. Reduction of QMB-only to SMB due to a change in income or annual income standard change, potentially MAGI-eligible, client did not return 7210(SDS 540)

Dakhligaaga la isku dheelitiray ee hadu wuxuu kaa dhigayaa in aad ka kor marto dakhliga loogu talagalay barnaamijka U qalmida ka Faa’iidaysiga Medicare (QMB) ee bixiya lacagaha qaybta kaaga soo aada Medicare (Medicare premiums), lacagaha caymiska laga jaro (deductibles), iyo qaar ka mid ah copay-ga. Barnaamijka kaliya ee aad u qalantid waa barnaamijka Dakhliga Hoose ee la Tilmaamay ee Faa’iidaysiga Medicare (SMB) ee bixiya lacagta qaybta kaaga soo aada Medicare Part B. (SMB ma bixiso lacagaha co-pay-ga ama lacagaha caymiska laga jaro ‘deductibles’). Taariikhdu markay ahayd insert date 7210 sent mm/dd/yy waxaanu codsanay in aad buuxiso oo aad soo celiso arjiga si uu kuu qiimeeyo Maamulka Caafimaadka Oregon kaasi oo loogu talagalay barnaamijyada kale ee Medicaid. Waxaan ku siinay ilaa insert 7210 due date mm/dd/yy si aad u dhammeystirto talaabadani. Ma aadan soo celin arjiga; sidaa darteed, Maamulka Caafimaadka Oregon go’aan kama gaari karo u qalmidaada barnaamijyada kale ee Medicaid.

OAR 410-120-1210, 461-001-0000(3), 461-110-0210, 461-110-0310, 461-110-0410, 461-110-0530(2), 461-155-0290, 461-155-0295(1), 461-160-0540, 461-160-0552, 461-170-0130, 461-180-0085

7f. Reduction of QMB-only to SMF due to a change in income or annual income standard change, potentially MAGI-eligible, client did not return 7210 (SDS 540)

Dakhligaaga la isku dheelitiray ee hadu wuxuu kaa dhigayaa in aad ka kor marto dakhliga loogu talagalay barnaamijka U qalmida ka Faa’iidaysiga Medicare (QMB) ee bixiya lacagaha qaybta kaaga soo aada Medicare (Medicare premiums), lacagaha caymiska laga jaro (deductibles), iyo qaar ka mid ah copay-ga. Barnaamijka kaliya ee aad u qalantid waa barnaamijka Shakhsiyaadka U qalma (SMF) ee bixiya lacagta qaybta kaaga soo aada Medicare Part B. (SMF ma bixiso lacagaha co-pay-ga ama lacagaha caymiska laga jaro ‘deductibles’). Taariikhdu markay ahayd insert date 7210 sent mm/dd/yy waxaanu codsanay in aad buuxiso oo aad soo celiso arjiga si uu kuu qiimeeyo Maamulka Caafimaadka Oregon kaasi oo loogu talagalay barnaamijyada kale ee Medicaid. Waxaan ku siinay ilaa insert 7210 due date mm/dd/yy si aad u dhammeystirto talaabadani. Ma aadan soo celin arjiga; sidaa darteed, Maamulka Caafimaadka Oregon go’aan kama gaari karo u qalmidaada barnaamijyada kale ee Medicaid.

OAR 410-120-1210, 461-001-0000(3), 461-110-0210, 461-110-0310, 461-110-0410, 461-110-0530(2), 461-155-0290, 461-155-0295(2), 461-160-0540, 461-160-0552, 461-170-0130, 461-180-0085

8a. Reduction of OSIPM to QMB due to no longer considered DAC eligible, not potentially MAGI-eligible (SDS 540)

Note: When removing the DAC C/D, make sure incoming code is SUPL or COMP so the case will recalculate.

Adjust language as needed if reducing to SMB or SMF and add GI rights language.

Faa’iidooyinkaaga caafimaad hoos ayaa loo dhigi doonaa laga bilaabo insert closure effective date mm/dd/yy. Hada ka dib uma qalantid Barnaamijka Dakhliga Dheeraadka ah ee Oregon-Caafimaadka (OSIPM) in uu noqdo Ilmaha Weyn ee Naafada ah (DAC) ahaan. Si loogu qalmo in OSIPM uu noqdo DAC ahaan, waa in aad buuxisaa shuruudaha looga baahan yahay Sugidda Dakhliga ee Kabista ah (SSI) marka laga reebo xaqiiqda ah in aad helaysid faa’iidadaada Social Security-ga ee ilmaha weyn ee naafada ah. Waxaad hada haysataa lacag ka badan xadka u yaala inta oggol yahay ee barnaamijka SSI; sidaa darteed, uma aadan qalmi lahayn SSI xataa haddii aadan helaynin faa’iidada ilmaha weyn ee naafada ah. Iyada oo aan la laheyn xaaladan la ilaalinayo ‘protected status’, waxaad hada ka kor martay xadka u yaala OSIPM. Barnaamijka kaliya ee aad u qalantid waa barnaamijka U qalmida ka Faa’iidaysiga Medicare (QMB) ee bixiya lacagta qaybta kaaga soo aada Medicare, iyo qaar ka mid ah copay-ga iyo lacagaha caymiska laga jaro (deductibles). Uma qalantid barnaamijyada MAGI Medicaid sababta oo ah uur ma lihid, iyada oo ay da’daadu ka weyn tahay 18 jir ama ka weyn tahay 64 jir haystana Medicare iyo adiga oo aan ahayn waalid iyo qaraabo xanaanaynaysa ilme kugu tiirsan oo kula nool.

OAR 410-120-1210; 410-200-0415(2), 410-200-0420(3), 410-200-0425(2), 410-200-0435(4), 461-001-0000(3), 461-135-0830, 461-155-0250, 461-155-0290, 461-160-0015, 461-160-0540; 461-160-0550, 461-160-0551, 461-160-0552, 461-110-0210, 461-110-0310, 461-110-0410, 461-110-0530(2),(4); 461-170-0130, 461-180-0085

8b. Reduction from OSIPM to QMB due to no longer considered DAC eligible, potentially MAGI-eligible, 7210 was returned, and MAGI was denied (SDS 540)

Note: When removing the DAC C/D, make sure incoming code is SUPL or COMP so the case will recalculate.

Adjust language as needed if reducing to SMB or SMF and add GI rights language.

Do not send notice and reduce medical until after 5503 determines eligibility for MAGI medical. If MAGI is approved, 5503 will take the necessary case actions and no notice is necessary.

Faa’iidooyinkaaga caafimaad hoos ayaa loo dhigi doonaa laga bilaabo insert closure effective date mm/dd/yy. Hada ka dib uma qalantid Barnaamijka Dakhliga Dheeraadka ah ee Oregon-Caafimaadka (OSIPM) in uu noqdo Ilmaha Weyn ee Naafada ah (DAC) ahaan. Si loogu qalmo in OSIPM uu noqdo DAC ahaan, waa in aad buuxisaa shuruudaha looga baahan yahay Sugidda Dakhliga ee Kabista ah (SSI) marka laga reebo xaqiiqda ah in aad helaysid faa’iidadaada Social Security-ga ee ilmaha weyn ee naafada ah. Waxaad hada haysataa lacag ka badan xadka u yaala inta la oggol yahay ee barnaamijka SSI; sidaa darteed, uma aadan qalmi lahayn SSI xataa haddii aadan helaynin faa’iidada ilmaha weyn ee naafada ah. Iyada oo aan la laheyn xaaladan la ilaalinayo ‘protected status’, waxaad hada ka kor martay xadka u yaala OSIPM. Barnaamijka kaliya ee aad u qalantid waa barnaamijka U qalmida ka Faa’iidaysiga Medicare (QMB) ee bixiya lacagta qaybta kaaga soo aada Medicare, iyo qaar ka mid ah copay-ga iyo lacagaha caymiska laga jaro (deductibles). Waxaad heli doontaa ogeysiin gooni oo ku saabsan u qalmidaada barnaamijyada kale ee Medicaid ee uu bixiyo Maamulka Caafimaadka Oregon.

OAR 410-120-1210; 461-001-0000(3), 461-135-0830, 461-155-0250, 461-155-0290, 461-160-0015, 461-160-0540; 461-160-0550, 461-160-0551, 461-160-0552, 461-110-0210, 461-110-0310, 461-110-0410, 461-110-0530(2),(4); 461-170-0130, 461-180-0085

8c. Reduction from OSIPM to QMB due to no longer considered DAC eligible, potentially MAGI-eligible, and client did not return 7210 (SDS 540)

Note: When removing the DAC C/D, make sure incoming code is SUPL or COMP so the case will recalculate.

Adjust language as needed if reducing to SMB or SMF and add the GI rights langauge.

Faa’iidooyinkaaga caafimaad hoos ayaa loo dhigi doonaa laga bilaabo insert closure effective date mm/dd/yy. Hada ka dib uma qalantid Barnaamijka Dakhliga Dheeraadka ah ee Oregon-Caafimaadka (OSIPM) in uu noqdo Ilmaha Weyn ee Naafada ah (DAC) ahaan. Si loogu qalmo in OSIPM uu noqdo DAC ahaan, waa in aad buuxisaa shuruudaha looga baahan yahay Sugidda Dakhliga ee Kabista ah (SSI) marka laga reebo xaqiiqda ah in aad helaysid faa’iidadaada Social Security-ga ee ilmaha weyn ee naafada ah. Waxaad hada haysataa lacag ka badan xadka u yaala inta la oggol yahay ee barnaamijka SSI; sidaa darteed, uma aadan qalmi lahayn SSI xataa haddii aadan helaynin faa’iidada ilmaha weyn ee naafada ah. Iyada oo aan la laheyn xaaladan la ilaalinayo ‘protected status’, waxaad hada ka kor martay xadka u yaala OSIPM. Barnaamijka kaliya ee aad u qalantid waa barnaamijka U qalmida ka Faa’iidaysiga Medicare (QMB) ee bixiya lacagta qaybta kaaga soo aada Medicare, iyo qaar ka mid ah copay-ga iyo lacagaha caymiska laga jaro (deductibles). Taariikhdu markay ahayd insert date 7210 sent mm/dd/yy waxaanu codsanay in aad buuxiso oo aad soo celiso arjiga si uu kuu qiimeeyo Maamulka Caafimaadka Oregon kaasi oo loogu talagalay barnaamijyada kale ee Medicaid. Waxaan ku siinay ilaa insert 7210 due date mm/dd/yy si aad u dhammeystirto talaabadani. Ma aadan soo celin arjiga; sidaa darteed, Maamulka Caafimaadka Oregon go’aan kama gaari karo u qalmidaada barnaamijyada kale ee Medicaid.

9. Reduction from QMB to SMB due to a change in income or yearly change in income standards - for OSIPM-eligible clients, no MAGI referral needed SDS 540)

Waxaad ogaan doontaa in aanay wax isbedel ahi aanu ku imaan faa’iidooyinkaaga. Dakhligaaga la isku dheelitiray ee hadu wuxuu kaa dhigayaa in aad ka kor marto dakhliga loogu talagalay Barnaamijkaaga Lacag Kaydsashada ee Medicare, Barnaamijka U qalmida ka Faa’iidaysiga Medicare (QMB) ee aad hada hesho ee bixiya lacagaha qaybta kaaga soo aada Medicare (Medicare premiums), lacagaha caymiska laga jaro (deductibles), iyo qaar ka mid ah copay-ga. Adigu, si kastaba ha ahaatee, waxaad u qalantaa barnaamijka Dakhliga Hoose ee la Tilmaamay ee Faa’iidaysiga Medicare (SMB) oo sii wadi doona bixinta lacagta qaybta kaaga soo aada Medicare Part B. Waad u sii qalantaa Barnaamijka Dakhliga Dheeraadka ah ee Oregon (OSIPM). OSIPM ayaa bixisa kharashyadaada caafimaad ee ayna bixinin Medicare. OAR 410-120-1210, 461-001-0000(3), 461-155-0290, 461-155-0295(1), 461-160-0540, 461-160-0552

10. Reduction from SMF to SBI due to 2017 change to SMF specific requirements, no MAGI referral needed (SDS 540)

Arki meysid wax isbedel ah oo ku yimid faa’iidooyinkaaga. Hada ka dib uma qalantid Barnaamijkaaga Lacag Kaydsashada ee Medicare, Barnaamijka Shakhsiyaadka U qalma (SMF) ee aad hada hesho ee bixiya lacagta qaybta kaaga soo aada Medicare Part B, sababta oo ah waxaad u qalantaa faa’iidooyinka kale ee Medicaid. Waxaad sii wadanaysaa helidda in la bixiyo lacagta qaybta kaaga soo aada Medicare Part B, maadaama aad sii wadato u qalmida Barnaamijka Dakhliga Dheeraadka ah ee Oregon-Caafimaadka (OSIPM). OSIPM ayaa bixisa kharashyadaada caafimaad ee ayna bixinin Medicare. OAR 410-120-1210, 461-135-0730(4)

11. Reduction from SMF to CBI due to 2017 change to SMF specific requirements, no MAGI referral needed (SDS 540)

*Note - also send the 540M for the new medical deduction

Hada ka dib uma qalantid Barnaamijkaaga Lacag Kaydsashada ee Medicare, Barnaamijka Shakhsiyaadka U qalma (SMF) ee aad hada hesho ee bixiya lacagta qaybta kaaga soo aada Medicare Part B, sababta oo ah waxaad u qalantaa faa’iidooyinka kale ee Medicaid. Waxaad sii wadataa u qalmida Barnaamijka Dakhliga Dheeraadka ah ee Oregon-Caafimaadka (OSIPM), waxaanad sii wadan doontaa in aad bixiso lacag ama lacagta adeega ee loogu talagalay adeegyada daryeelka mudada fog ee aad hesho. Marka aanu joojino bixinta lacagta qaybta kaaga soo aada Medicare Part B, lacagta qaybta kaaga soo aadaysa waxaa si toos ah looga jari doonaa lacagtaada Social Security-ga. Tirada lacagta aad ka hesho Social Security-ga waxay noqon doontaa mid yar, laakiin lacagta aad ku bixiso adeegyadaada isla tiro la mid ah taasi ayaa hoos loo dhigi doonaa. Habkani waxaad sii wadan doontaa helidda faa’iidooyinka guud oo isku mid ah. OAR 410-120-1210, 461-135-0730(4), 461-160-0030, 461-160-0055(3), 461-160-0610, 461-160-0620(3)(g)

12. Reduction from SMB to SBI due to a change in income, no MAGI referral needed (SDS 540)

Arki meysid wax isbedel ah oo ku yimid faa’iidooyinkaaga. Dakhligaaga la isku dheelitiray ee hadu wuxuu kaa dhigayaa in aad ka kor marto dakhliga loogu talagalay Barnaamijkaaga Lacag Kaydsashada ee Medicare, barnaamijka Dakhliga Hoose ee la Tilmaamay ee Faa’iidaysiga Medicare (SMB) ee aad hada hesho ee bixiya lacagta qaybta kaaga soo aada Medicare Part B. Uma qalantid Barnaamijka Shakhsiyaadka U qalma ee Lacag Kaydsashada ee Medicare (SMF) sababta oo ah waxaad weli u qalantaa isla markaana helaysaa Medicaid. Waxaad sii wadanaysaa helidda in la bixiyo lacagta qaybta kaaga soo aada Medicare Part B, maadaama aad sii wadato u qalmida Barnaamijka Dakhliga Dheeraadka ah ee Oregon-Caafimaadka (OSIPM). OSIPM ayaa bixisa kharashyadaada caafimaad ee ayna bixinin Medicare. OAR 410-120-1210, 461-001-0000(3), 461-135-0730(4), 461-155-0295(1), 461-160-0540(4), 461-160-0552

13. Reduction of SMB to CBI due to a change in income or yearly change in income standards, no MAGI referral needed (SDS 540)

*Note - also send the 540M for the new medical deduction

Dakhligaaga la isku dheelitiray ee hadu wuxuu kaa dhigayaa in aad ka kor marto dakhliga loogu talagalay Barnaamijkaaga Lacag Kaydsashada ee Medicare, barnaamijka Dakhliga Hoose ee la Tilmaamay ee Faa’iidaysiga Medicare (SMB) ee aad hada hesho ee bixiya lacagta qaybta kaaga soo aada Medicare Part B. Hada ka dib uma qalantid Barnaamijka Shakhsiyaadka U qalma ee Lacag Kaydsashada ee Medicare (SMF) sababta oo ah waxaad weli u qalantaa isla markaana helaysaa faa’iidooyinka Medicaid. Waxaad sii wadataa u qalmida Barnaamijka Dakhliga Dheeraadka ah ee Oregon-Caafimaadka (OSIPM), waxaanad sii wadan doontaa in aad bixiso lacag ama lacagta adeega ee loogu talagalay adeegyada daryeelka mudada fog ee aad hesho. Marka aanu joojino bixinta lacagta qaybta kaaga soo aada Medicare Part B, lacagta qaybta kaaga soo aadaysa waxaa si toos ah looga jari doonaa lacagtaada Social Security-ga. Tirada lacagta aad ka hesho Social Security-ga waxay noqon doontaa mid yar, laakiin lacagta aad ku bixiso adeegyadaada isla tiro la mid ah taasi ayaa hoos loo dhigi doonaa. Habkani waxaad sii wadan doontaa helidda faa’iidooyinka guud oo isku mid ah. OAR 410-120-1210, 461-001-0000(3), 461-135-0730(4), 461-155-0295(1), 461-160-0030, 461-160-0055(3), 461-160-0540(4), 461-160-0552, 461-160-0610, 461-160-0620(3)(g)

14. Change from SBI to CBI due to a change in income, ongoing service client with an existing service liability, no MAGI referral needed (use the SDS 540M)

15. Change from SBI to CBI due to a change in income, ongoing service client with a first-time service liability, no MAGI referral needed (use the SDS 540M or add to 540P)

16. Change from SBI to CBI due to a change in income, new service client who was already receiving OSIPM and SBI no MAGI referral needed (add this language to the SDS 541)

17. Reduction from MAGI Medicaid to QMB-BAS

OHA/5503 is responsible for notifying MAGI recipients of closure. An approval notice will be mailed automatically when the case is opened on CMS.

18. Reduction from MAGI Medicaid to SMB or SMF.

OHA/5503 is responsible for notifying MAGI recipients of closure. An approval notice will be mailed automatically when the case is opened on CMS.

Medical Denial

1. Failure to provide requested verification (SDS 540)

Provide client with date stamped 7210 application form. Instruct the client to complete the application, sign it, and return it to address printed on the 7210 form.

*No 7210 is needed if this was the result of a ONE referral from 5503. If so, delete the last two sentences.

Arjigaaga loogu talagalay Choose program - Barnaamijka Dakhliga Caafimaad ee Dheeraadka ah ee Oregon (OSIPM)/Barnaamijka Lacag Kaydsashada ee (QMB/SMB/SMF) waa la diiday. Waxaanu codsanay caddeyn kaa socota oo ku saabsan insert verification type requested. Ilaa iyo hada, ma aynaan helin caddeytan la codsaday. Iyada oo sababtu tahay anaga oo aan helin macluumaadkan, uma qalantid faa’iidooyinka caafimaad ee uu bixiyo Barnaamijka Dadka Waayeelka ah ee Naafada ah. Waxaa laga yaabaa in aad u qalanto barnaamijyada kale ee caafimaad ee uu bixiyo Maamulka Caafimaadka Oregon (OHA). Waxaa lagu siiyay arji waxaana kula soo xiriiri doona OHA kaasi oo ku saabsan u qalmidaada barnaamijyadooda.

OAR 410-120-1210, 461-105-0020(1),(2); 461-115-0010(1),(2),(3); 461-115-0020; 461-115-0190(1); 461-115-0700; 461-115-0610(1),(2); 461-115-0430(1),(2)

2. Failure to complete interview (SDS 540)

*No referral to 5503 necessary.

3. Denial of OSIPM for being over income and ineligible for all APD medical programs (SDS 540)

Provide client with date stamped 7210 application form. Instruct the client to complete the application, sign it, and return it to address printed on the 7210 form.

*No 7210 is needed if this was the result of a ONE referral from 5503. If so, delete the last two sentences.

Uma qalantid Barnaamijka Dakhliga Dheeraadka ah ee Oregon-Caafimaadka (OSIPM) sababta oo ah waxaad ka kor martay heerka dakhliga u yaala. Uma qalantid barnaamijyada gargaarka caafimaad ee ay maamusho Dadka Waayeelka ah ee Naafada ah (APD). Si loogu qalmo Barnaamijka Dakhliga Caafimaad ee Dheeraadka ah ee Oregon (OSIPM), waa in ay da’daadu tahay 65 jir ama ka wayn tahay, aadan indho qabin, ama leedahay naafanimo buuxinaysa heerarka u yaala Social Security-ga ISLA MARKAANA leedahay u qalmid la aqbalay ama la dhowray ama aad ku siman tahay xadka u yaala dakhliga iyo ilaha. Si loogu qalmo Barnaamijyada Lacag Kaydsashada ee Medicare (QMB, SMB, SMF) waa in aad leedahay Medicare Part A isla markaana leedahay dakhli ku siman xadka u yaala barnaamijka la oggol yahay. Waa in aad sidoo kale buuxisaa dhammaan shuruudaha looga baahan yahay u qalmida waxyaalaha aan dhaqaalaha ku xirnayn oo aad dhammeystirtaa arjiga codsi iyo nidaamka caddeynta si aad aad ugu qalanto barnaamijyada caafimaad ee APD. Waxaa laga yaabaa in aad u qalanto barnaamijyada kale ee caafimaad ee uu bixiyo Maamulka Caafimaadka Oregon (OHA). Waxaa lagu siiyay arji waxaana kula soo xiriiri doona OHA kaasi oo ku saabsan u qalmidaada barnaamijyadooda.

OAR 410-120-1210; 461-001-0000(3); 461-155-0250; 461-110-0210; 461-110-0310; 461-110-0410; 461-110-0530(2),(4); 461-115-0010(1),(2),(3); 461-115-0020; 461-115-0230(5); 461-115-0540; 461-115-0610(1),(2),(3); 461-115-0700; 461-120-0315; 461-120-0330(1),(3); 461-120-0345; 461-120-0510(1),(4),(5),(6),(7); 461-125-0310; 461-125-0330; 461-125-0350; 461-125-0370; 461-135-0730; 461-135-0745; 461-135-0750; 461-135-0771; 461-135-0780; 461-135-0790; 461-135-0800; 461-135-0820; 461-135-0830; 461-155-0290; 461-155-0295; 461-160-0010(3),(4),(5); 461-160-0015(3),(4),(5); 461-160-0540; 461-160-0550; 461-160-0551; 461-160-0552; 461-170-0130; 461-180-0085

4. Denial of OSIPM for being over income - current QMB-BAS client who was denied services. (SDS 540)

Note: Send separate service denial notice.

Uma qalantid Barnaamijka Dakhliga Dheeraadka ah ee Oregon-Caafimaadka (OSIPM) sababta oo ah waxaad ka kor martay heerka dakhliga u yaala. Barnaamijka kaliya ee ay maamusho Dadka Waayeelka ah ee Naafada ah ee aad u qalanto waa barnaamijka aad hada helayso – barnaamijka U qalmida ka Faa’iidaysiga Medicare (QMB-BAS) ee bixiya lacagaha qaybta kaaga soo aada Medicare (Medicare premiums), qaar ka mid ah copay-ga & lacagaha caymiska laga jaro (deductibles).

OAR 410-120-1210; 461-001-0000(3); 461-155-0250; 461-155-0290; 461-160-0540(1),(2); 461-160-0550, 461-160-0551; 461-160-0552; 461-170-0130; 461-180-0085

5. Denial of OSIPM for being over income - current SMB/SMF client who was denied services. (SDS 540)

Note: Send separate service denial notice

Uma qalantid Barnaamijka Dakhliga Dheeraadka ah ee Oregon-Caafimaadka (OSIPM) sababta oo ah waxaad ka kor martay heerka dakhliga u yaala. Barnaamijka kaliya ee ay maamusho Dadka Waayeelka ah ee Naafada ah ee aad u qalanto waa barnaamijka aad hada helayso – Choose program - barnaamijka Dakhliga Hoose ee la Tilmaamay ee Faa’iidaysiga Medicare (SMB)/ barnaamijka Shakhsiyaadka U qalma (SMF) program oo sii wadi doona bixinta lacagta qaybta kaaga soo aada Medicare Part B.

OAR 410-120-1210, 461-001-0000(3); 461-155-0250; 461-155-0290; 461-155-0295; 461-160-0540(1),(2); 461-160-0550; 461-160-0551; 461-160-0552; 461-170-0130; 461-180-0085

6. Denial of QMB programs for being over income and ineligible for all APD medical programs (SDS 540)

Provide individual with date-stamped 7210 application form with instructions to complete and sign the application and return it to address printed on the 7210 form.

*No 7210 is needed if this was the result of a ONE referral from 5503. If so, delete the last two sentences

Uma qalantid Barnaamijka Lacag Kaydsashada ee Medicare (QMB/SMB/SMF) sababta oo ah waxaad ka kor martay heerka dakhliga u yaala. Uma qalantid barnaamijyada gargaarka caafimaad ee ay maamusho Dadka Waayeelka ah ee Naafada ah (APD). Si loogu qalmo Barnaamijka Dakhliga Caafimaad ee Dheeraadka ah ee Oregon (OSIPM), waa in ay da’daadu tahay 65 jir ama ka wayn tahay, aadan indho qabin, ama leedahay naafanimo buuxinaysa heerarka u yaala Social Security-ga ISLA MARKAANA leedahay u qalmid la aqbalay ama la dhowray ama aad ku siman tahay xadka u yaala dakhliga iyo ilaha. Si loogu qalmo Barnaamijyada Lacag Kaydsashada ee Medicare (QMB, SMB, SMF) waa in aad leedahay Medicare Part A isla markaana leedahay dakhli ku siman xadka u yaala barnaamijka la oggol yahay. Waa in aad sidoo kale buuxisaa dhammaan shuruudaha looga baahan yahay u qalmida waxyaalaha aan dhaqaalaha ku xirnayn oo aad dhammeystirtaa arjiga codsi iyo nidaamka caddeynta si aad aad ugu qalanto barnaamijyada caafimaad ee APD. Waxaa laga yaabaa in aad u qalanto barnaamijyada kale ee caafimaad ee uu bixiyo Maamulka Caafimaadka Oregon (OHA). Waxaa lagu siiyay arji waxaana kula soo xiriiri doona OHA kaasi oo ku saabsan u qalmidaada barnaamijyadooda.

OAR 410-120-1210; 461-155-0290; 461-155-0295; 461-110-0210; 461-110-0310; 461-110-0410; 461-110-0530(2),(4); 461-115-0010(1),(2),(3); 461-115-0020; 461-115-0230(5); 461-115-0540; 461-115-0610(1),(2),(3); 461-115-0700; 461-120-0315; 461-120-0330(1),(3); 461-120-0345; 461-120-0510(1),(4),(5),(6),(7); 461-125-0310; 461-125-0330; 461-125-0350; 461-125-0370; 461-135-0730; 461-135-0745; 461-135-0750; 461-135-0771; 461-135-0780; 461-135-0790; 461-135-0800; 461-135-0820; 461-135-0830; 461-155-0250; 461-160-0010(3),(4),(5); 461-160-0015(3),(4),(5); 461-160-0540; 461-160-0550; 461-160-0551; 461-160-0552; 461-170-0130; 461-180-0085

7. Denial of OSIPM for being over resources and ineligible for all APD medical programs (SDS 540)

Provide individual with date-stamped 7210 application form with instructions to complete and sign the application and return it to address printed on the 7210 form.

*No 7210 is needed if this was the result of a ONE referral from 5503. If so, delete the last two sentences.

Uma qalantid Barnaamijka Dakhliga Dheeraadka ah ee Oregon-Caafimaadka (OSIPM) sababta oo ah waxaad haysataa kheyraad ka badan xadka u yaala. Uma qalantid barnaamijyada gargaarka caafimaad ee ay maamusho Dadka Waayeelka ah ee Naafada ah (APD). Si loogu qalmo Barnaamijka Dakhliga Caafimaad ee Dheeraadka ah ee Oregon (OSIPM), waa in ay da’daadu tahay 65 jir ama ka wayn tahay, aadan indho qabin, ama leedahay naafanimo buuxinaysa heerarka u yaala Social Security-ga ISLA MARKAANA leedahay u qalmid la aqbalay ama la dhowray ama aad ku siman tahay xadka u yaala dakhliga iyo ilaha. Si loogu qalmo Barnaamijyada Lacag Kaydsashada ee Medicare (QMB, SMB, SMF) waa in aad leedahay Medicare Part A isla markaana leedahay dakhli ku siman xadka u yaala barnaamijka la oggol yahay. Waa in aad sidoo kale buuxisaa dhammaan shuruudaha looga baahan yahay u qalmida waxyaalaha aan dhaqaalaha ku xirnayn oo aad dhammeystirtaa arjiga codsi iyo nidaamka caddeynta si aad aad ugu qalanto barnaamijyada caafimaad ee APD. Waxaa laga yaabaa in aad u qalanto barnaamijyada kale ee caafimaad ee uu bixiyo Maamulka Caafimaadka Oregon (OHA). Waxaa lagu siiyay arji waxaana kula soo xiriiri doona OHA kaasi oo ku saabsan u qalmidaada barnaamijyadooda.

8. Denial of presumptive OSIPM based on binding SSA decision and is not eligible for any APD medical - individual is receiving MAGI and applied for GA (SDS 540)

Waa in la go'aamiyaa in aad tahay naafo si aad uga qalanto Barnaamijka Dakhliga Dheeraadka ah ee Oregon-Caafimaadka (OSIPM). Go’aamada naafanimada la xiriira ee Xafiiska Social Security-ga (SSA) waxay ku xiran yihiin hay'adda gobolka ee Medicaid, xataa haddii aad rafcaan ka qaadanayso. SSA waxay go'aansatay in aadan naafo ahayn. Inta aan ka ognahay, ma lihid xaalad naafanimo oo cusub oo SSA ay ku fashilantay in ay tixgeliso. Uma qalantid barnaamijyada gargaarka caafimaad ee ay maamusho Dadka Waayeelka ah ee Naafada ah (APD). Si loogu qalmo Barnaamijka Dakhliga Caafimaad ee Dheeraadka ah ee Oregon (OSIPM), waa in ay da’daadu tahay 65 jir ama ka wayn tahay, aadan indho qabin, ama leedahay naafanimo buuxinaysa heerarka u yaala Social Security-ga ISLA MARKAANA leedahay u qalmid la aqbalay ama la dhowray ama aad ku siman tahay xadka u yaala dakhliga iyo ilaha. Si loogu qalmo Barnaamijyada Lacag Kaydsashada ee Medicare (QMB, SMB, SMF) waa in aad leedahay Medicare Part A isla markaana leedahay dakhli ku siman xadka u yaala barnaamijka la oggol yahay. Waa in aad sidoo kale buuxisaa dhammaan shuruudaha looga baahan yahay u qalmida waxyaalaha aan dhaqaalaha ku xirnayn oo aad dhammeystirtaa arjiga codsi iyo nidaamka caddeynta si aad aad ugu qalanto barnaamijyada caafimaad ee APD. Tani ma bedelayso ama ma saameynayso wixii faa’iidooyin Medicaid ah ee aad ka helaysid Maamulka Caafimaadka Oregon.

OAR 410-120-1210; 461-125-0310; 461-125-0370(1),(2),(3),(4); 461-110-0210; 461-110-0310; 461-110-0410; 461-110-0530(2),(4); 461-115-0010(1),(2),(3); 461-115-0020; 461-115-0230(5); 461-115-0540; 461-115-0610(1),(2),(3); 461-115-0700; 461-120-0315; 461-120-0330(1),(3); 461-120-0345; 461-120-0510(1),(4),(5),(6),(7); 461-125-0330; 461-125-0350; 461-135-0730; 461-135-0745; 461-135-0750; 461-135-0771; 461-135-0780; 461-135-0790; 461-135-0800; 461-135-0820; 461-135-0830; 461-155-0250; 461-155-0290; 461-155-0295; 461-160-0010(3),(4),(5); 461-160-0015(3),(4),(5); 461-160-0540; 461-160-0550; 461-160-0551; 461-160-0552; 461-170-0130; 461-180-0085

9. Denial of presumptive OSIPM based on binding SSA decision, client was found ineligible for MAGI, was applying for services, EPD, or GA, and is not eligible for any APD medical (SDS 540)

Waa in la go'aamiyaa in aad tahay naafo si aad uga qalanto Barnaamijka Dakhliga Dheeraadka ah ee Oregon-Caafimaadka (OSIPM) ee bixiya xirmada faa’iidada Plus. Go’aamada naafanimada la xiriira ee Xafiiska Social Security-ga (SSA) waxay ku xiran yihiin hay'adda gobolka ee Medicaid, xataa haddii aad rafcaan ka qaadanayso. SSA waxay go'aansatay in aadan naafo ahayn. Inta aan ka ognahay, ma lihid xaalad naafanimo oo cusub oo SSA ay ku fashilantay in ay tixgeliso. Uma qalantid barnaamijyada gargaarka caafimaad ee ay maamusho Dadka Waayeelka ah ee Naafada ah (APD). Si loogu qalmo Barnaamijka Dakhliga Caafimaad ee Dheeraadka ah ee Oregon (OSIPM), waa in ay da’daadu tahay 65 jir ama ka wayn tahay, aadan indho qabin, ama leedahay naafanimo buuxinaysa heerarka u yaala Social Security-ga ISLA MARKAANA leedahay u qalmid la aqbalay ama la dhowray ama aad ku siman tahay xadka u yaala dakhliga iyo ilaha. Si loogu qalmo Barnaamijyada Lacag Kaydsashada ee Medicare (QMB, SMB, SMF) waa in aad leedahay Medicare Part A isla markaana leedahay dakhli ku siman xadka u yaala barnaamijka la oggol yahay. Waa in aad sidoo kale buuxisaa dhammaan shuruudaha looga baahan yahay u qalmida waxyaalaha aan dhaqaalaha ku xirnayn oo aad dhammeystirtaa arjiga codsi iyo nidaamka caddeynta si aad aad ugu qalanto barnaamijyada caafimaad ee APD. Waa in aad ogeysiin ka heshay Maamulka Caafimaadka Oregon kaasi oo ku saabsan u qalmidaada loogu talagalay barnaamijyada ay maamusho Medicaid.

OAR 410-120-1210; 461-125-0310; 461-125-0370(1),(2),(3),(4),(5),(6); 461-110-0210; 461-110-0310; 461-110-0410; 461-110-0530(2),(4); 461-115-0010(1),(2),(3); 461-115-0020; 461-115-0230(5); 461-115-0540; 461-115-0610(1),(2),(3); 461-115-0700; 461-120-0315; 461-120-0330(1),(3); 461-120-0345; 461-120-0510(1),(4),(5),(6),(7); 461-125-0330; 461-125-0350; 461-135-0730; 461-135-0745; 461-135-0750; 461-135-0771; 461-135-0780; 461-135-0790; 461-135-0800; 461-135-0820; 461-135-0830; 461-155-0250; 461-155-0290; 461-155-0295; 461-160-0010(3),(4),(5); 461-160-0015(3),(4),(5); 461-160-0540; 461-160-0550; 461-160-0551; 461-160-0552; 461-170-0130; 461-180-0085

10. Denial of presumptive OSIPM based on binding SSA decision, client has not applied for or is not receiving MAGI, was applying for services or EPD and is not eligible for any APD medical* (SDS 540)

*If possible, provide a date-stamped 7210 or refer individual to a community partner in lieu of having individual complete 539A and completing a PMDDT referral. If a 539A has already been submitted and individual does not wish to withdraw, provide a date-stamped 7210 application form, instruct the individual to complete and sign the application and return it to address printed on the 7210 form, complete the PMDDT referral process and use the language below in the event of a binding SSA decision.

Waa in la go'aamiyaa in aad tahay naafo si aad uga qalanto Barnaamijka Dakhliga Dheeraadka ah ee Oregon-Caafimaadka (OSIPM) ee bixiya xirmada faa’iidada Plus. Go’aamada naafanimada la xiriira ee Xafiiska Social Security-ga (SSA) waxay ku xiran yihiin hay'adda gobolka ee Medicaid, xataa haddii aad rafcaan ka qaadanayso. SSA waxay go'aansatay in aadan naafo ahayn. Inta aan ka ognahay, ma lihid xaalad naafanimo oo cusub oo SSA ay ku fashilantay in ay tixgeliso. Uma qalantid barnaamijyada gargaarka caafimaad ee ay maamusho Dadka Waayeelka ah ee Naafada ah (APD). Si loogu qalmo Barnaamijka Dakhliga Caafimaad ee Dheeraadka ah ee Oregon (OSIPM), waa in ay da’daadu tahay 65 jir ama ka wayn tahay, aadan indho qabin, ama leedahay naafanimo buuxinaysa heerarka u yaala Social Security-ga ISLA MARKAANA leedahay u qalmid la aqbalay ama la dhowray ama aad ku siman tahay xadka u yaala dakhliga iyo ilaha. Si loogu qalmo Barnaamijyada Lacag Kaydsashada ee Medicare (QMB, SMB, SMF) waa in aad leedahay Medicare Part A isla markaana leedahay dakhli ku siman xadka u yaala barnaamijka la oggol yahay. Waa in aad sidoo kale buuxisaa dhammaan shuruudaha looga baahan yahay u qalmida waxyaalaha aan dhaqaalaha ku xirnayn oo aad dhammeystirtaa arjiga codsi iyo nidaamka caddeynta si aad aad ugu qalanto barnaamijyada caafimaad ee APD. Waxaa laga yaabaa in aad u qalanto barnaamijyada kale ee caafimaad ee uu bixiyo Maamulka Caafimaadka Oregon (OHA). Waxaa lagu siiyay arji waxaana kula soo xiriiri doona OHA kaasi oo ku saabsan u qalmidaada barnaamijyada ay leedahay.

11. Denial of OSIPM based on PMDDT decision that individual isn’t disabled and is not eligible for any APD medical - individual is receiving MAGI and applied for GA(SDS 540)

Waa in la go'aamiyaa in aad tahay naafo si aad uga qalanto Barnaamijka Dakhliga Dheeraadka ah ee Oregon-Caafimaadka (OSIPM) sida ay dhigayaan heerarka u yaala naafanimada ee Xafiiska Social Security-ga (SSA). Ka dib markii dib loo fiiriyay caafimaadka iyo caddeynta kale ee dacwadaada, Waaxdu waxay go’aamisay in aadan buuxinayn heerarka u yaala naafanimada SSA. Uma qalantid barnaamijyada gargaarka caafimaad ee ay maamusho Dadka Waayeelka ah ee Naafada ah (APD). Si loogu qalmo Barnaamijka Dakhliga Caafimaad ee Dheeraadka ah ee Oregon (OSIPM), waa in ay da’daadu tahay 65 jir ama ka wayn tahay, aadan indho qabin, ama leedahay naafanimo buuxinaysa heerarka u yaala Social Security-ga ISLA MARKAANA leedahay u qalmid la aqbalay ama la dhowray ama aad ku siman tahay xadka u yaala dakhliga iyo ilaha. Si loogu qalmo Barnaamijyada Lacag Kaydsashada ee Medicare (QMB, SMB, SMF) waa in aad leedahay Medicare Part A isla markaana leedahay dakhli ku siman xadka u yaala barnaamijka la oggol yahay. Waa in aad sidoo kale buuxisaa dhammaan shuruudaha looga baahan yahay u qalmida waxyaalaha aan dhaqaalaha ku xirnayn oo aad dhammeystirtaa arjiga codsi iyo nidaamka caddeynta si aad aad ugu qalanto barnaamijyada caafimaad ee APD. Tani ma bedelayso ama ma saameynayso wixii faa’iidooyin Medicaid ah ee aad ka helaysid Maamulka Caafimaadka Oregon.

12. Denial of OSIPM based on PMDDT decision that individual isn’t disabled, was found ineligible for MAGI, was applying for services or EPD, and is not eligible for any APD medical (SDS 540)

Waa in la go'aamiyaa in aad tahay naafo si aad uga qalanto Barnaamijka Dakhliga Dheeraadka ah ee Oregon-Caafimaadka (OSIPM) sida ay dhigayaan heerarka u yaala naafanimada ee Xafiiska Social Security-ga (SSA). Ka dib markii dib loo fiiriyay caafimaadka iyo caddeynta kale ee dacwadaada, Waaxdu waxay go’aamisay in aadan buuxinayn heerarka u yaala naafanimada SSA. Uma qalantid barnaamijyada gargaarka caafimaad ee ay maamusho Dadka Waayeelka ah ee Naafada ah (APD). Si loogu qalmo Barnaamijka Dakhliga Caafimaad ee Dheeraadka ah ee Oregon (OSIPM), waa in ay da’daadu tahay 65 jir ama ka wayn tahay, aadan indho qabin, ama leedahay naafanimo buuxinaysa heerarka u yaala Social Security-ga ISLA MARKAANA leedahay u qalmid la aqbalay ama la dhowray ama aad ku siman tahay xadka u yaala dakhliga iyo ilaha. Si loogu qalmo Barnaamijyada Lacag Kaydsashada ee Medicare (QMB, SMB, SMF) waa in aad leedahay Medicare Part A isla markaana leedahay dakhli ku siman xadka u yaala barnaamijka la oggol yahay. Waa in aad sidoo kale buuxisaa dhammaan shuruudaha looga baahan yahay u qalmida waxyaalaha aan dhaqaalaha ku xirnayn oo aad dhammeystirtaa arjiga codsi iyo nidaamka caddeynta si aad aad ugu qalanto barnaamijyada caafimaad ee APD. Waa in aad ogeysiin ka heshay Maamulka Caafimaadka Oregon kaasi oo ku saabsan u qalmidaada loogu talagalay barnaamijyada ay maamusho Medicaid.

13. Denial of OSIPM due to failure to comply with PMDDT and is not eligible for any APD medical program - individual is receiving MAGI and applied for GA (SDS 540)

Arjigaaga loogu talagalay faa’iidooyinka caafimaad ee hoos yimaada Barnaamijka Dakhliga Caafimaad ee Dheeraadka ah ee Oregon (OSIPM) waa la diiday sababta oo ah waxaad ku guuldareysatay in aad u hoggaansanto shuruudaha looga baahan yahay u qalmida. Si loogu qalmo OSIPM, macaamiishu waa in ay wada shaqayn ka sameeyaan helitaanka dukumentiyo caafimaad oo ku filan oo loogu talagalay Waaxda si ay go’aan uga gaarto u qalmida. Waxaad ku guuldareysatay in aad wada shaqayn ka samayso helitaanka dukumentiyo caafimaad oo ku filan adiga oo ku guuldareystay in aad ka qayb qaadato baaritaan caafimaad oo la qorsheeyey date of missed medical exam mm/dd/yy waqtiga time of missed medical exam hh:mm oo lala lahaa Dr. doctor’s name isla markaana balanta kale dib loo qabtay date of rescheduled medical exam m/dd/yy waqtiga time of rescheduled medical exam hh:mm. Uma qalantid barnaamijyada gargaarka caafimaad ee ay maamusho Dadka Waayeelka ah ee Naafada ah (APD). Si loogu qalmo Barnaamijka Dakhliga Caafimaad ee Dheeraadka ah ee Oregon (OSIPM), waa in ay da’daadu tahay 65 jir ama ka wayn tahay, aadan indho qabin, ama leedahay naafanimo buuxinaysa heerarka u yaala Xafiiska Social Security-ga ISLA MARKAANA leedahay u qalmid la aqbalay ama la dhowray ama aad ku siman tahay tahay xadka u yaala dakhliga iyo ilaha. Si loogu qalmo Barnaamijyada Lacag Kaydsashada ee Medicare (QMB, SMB, SMF) waa in aad leedahay Medicare Part A isla markaana leedahay dakhli ku siman xadka u yaala barnaamijka la oggol yahay. Waa in aad sidoo kale buuxisaa dhammaan shuruudaha looga baahan yahay u qalmida waxyaalaha aan dhaqaalaha ku xirnayn oo aad dhammeystirtaa arjiga codsi iyo nidaamka caddeynta si aad aad ugu qalanto barnaamijyada caafimaad ee APD. Tani ma bedelayso ama ma saameynayso wixii faa’iidooyin Medicaid ah ee aad ka helaysid Maamulka Caafimaadka Oregon.

OAR 410-120-1210; 461-105-0020(1),(2),(6); 461-125-0310; 461-125-0370(1),(2),(3),(4),(5),(6); 461-110-0210; 461-110-0310; 461-110-0410; 461-110-0530(2),(4); 461-115-0010(1),(2),(3); 461-115-0020; 461-115-0230(5); 461-115-0540; 461-115-0610(1),(2),(3); 461-115-0700; 461-120-0315; 461-120-0330(1),(3); 461-120-0345; 461-120-0510(1),(4),(5),(6),(7); 461-125-0330; 461-125-0350; 461-135-0730; 461-135-0745; 461-135-0750; 461-135-0771; 461-135-0780; 461-135-0790; 461-135-0800; 461-135-0820; 461-135-0830; 461-155-0250; 461-155-0290; 461-155-0295; 461-160-0010(3),(4),(5); 461-160-0015(3),(4),(5); 461-160-0540; 461-160-0550; 461-160-0551; 461-160-0552; 461-170-0130; 461-180-0085

14. Denial of OSIPM due to failure to comply with PMDDT, was found ineligible for MAGI, was applying for services or EPD, and is not eligible for any APD medical program (SDS 540)

Arjigaaga loogu talagalay faa’iidooyinka caafimaad ee hoos yimaada Barnaamijka Dakhliga Caafimaad ee Dheeraadka ah ee Oregon (OSIPM) waa la diiday sababta oo ah waxaad ku guuldareysatay in aad u hoggaansanto shuruudaha looga baahan yahay u qalmida. Si loogu qalmo OSIPM, macaamiishu waa in ay wada shaqayn ka sameeyaan helitaanka dukumentiyo caafimaad oo ku filan oo loogu talagalay Waaxda si ay go’aan uga gaarto u qalmida. Waxaad ku guuldareysatay in aad wada shaqayn ka samayso helitaanka dukumentiyo caafimaad oo ku filan adiga oo ku guuldareystay in aad ka qayb qaadato baaritaan caafimaad oo la qorsheeyey date of missed medical exam mm/dd/yy waqtiga time of missed medical exam hh:mm oo lala lahaa Dr. doctor’s name isla markaana balanta kale dib loo qabtay date of rescheduled medical exam m/dd/yy waqtiga time of rescheduled medical exam hh:mm. Uma qalantid barnaamijyada gargaarka caafimaad ee ay maamusho Dadka Waayeelka ah ee Naafada ah (APD). Si loogu qalmo Barnaamijka Dakhliga Caafimaad ee Dheeraadka ah ee Oregon (OSIPM), waa in ay da’daadu tahay 65 jir ama ka wayn tahay, aadan indho qabin, ama leedahay naafanimo buuxinaysa heerarka u yaala Xafiiska Social Security-ga ISLA MARKAANA leedahay u qalmid la aqbalay ama la dhowray ama aad ku siman tahay tahay xadka u yaala dakhliga iyo ilaha. Si loogu qalmo Barnaamijyada Lacag Kaydsashada ee Medicare (QMB, SMB, SMF) waa in aad leedahay Medicare Part A isla markaana leedahay dakhli ku siman xadka u yaala barnaamijka la oggol yahay. Waa in aad sidoo kale buuxisaa dhammaan shuruudaha looga baahan yahay u qalmida waxyaalaha aan dhaqaalaha ku xirnayn oo aad dhammeystirtaa arjiga codsi iyo nidaamka caddeynta si aad aad ugu qalanto barnaamijyada caafimaad ee APD. Waa in aad ogeysiin ka heshay Maamulka Caafimaadka Oregon kaasi oo ku saabsan u qalmidaada loogu talagalay barnaamijyada ay maamusho Medicaid.

15. Denial of presumptive OSIPM due to failure to comply with pursuit of SSDI, has been found ineligible for MAGI, was applying for services or EPD, and is not eligible for any APD medical (SDS 540)

Waxaanu codsanay in aad raacdo arjigaaga loogu talagalay faa’iidooyinka Social Security-ga ee ka socda Xafiiska Social Security-ga. Ma aynaan helin caddeyn tilmaamaysa in aad taasi sameysay. Iyada oo sababtu tahay anaga oo aan helin macluumaadkan, arjigaagii gargaarka caafimaad waa la diiday. Uma qalantid barnaamijyada gargaarka caafimaad ee ay maamusho Dadka Waayeelka ah ee Naafada ah (APD). Si loogu qalmo Barnaamijka Dakhliga Caafimaad ee Dheeraadka ah ee Oregon (OSIPM), waa in ay da’daadu tahay 65 jir ama ka wayn tahay, aadan indho qabin, ama leedahay naafanimo buuxinaysa heerarka u yaala Xafiiska Social Security-ga ISLA MARKAANA leedahay u qalmid la aqbalay ama la dhowray ama aad ku siman tahay tahay xadka u yaala dakhliga iyo ilaha. Si loogu qalmo Barnaamijyada Lacag Kaydsashada ee Medicare (QMB, SMB, SMF) waa in aad leedahay Medicare Part A isla markaana leedahay dakhli ku siman xadka u yaala barnaamijka la oggol yahay. Waa in aad sidoo kale buuxisaa dhammaan shuruudaha looga baahan yahay u qalmida waxyaalaha aan dhaqaalaha ku xirnayn oo aad dhammeystirtaa arjiga codsi iyo nidaamka caddeynta si aad aad ugu qalanto barnaamijyada caafimaad ee APD. Waa in aad ogeysiin ka heshay Maamulka Caafimaadka Oregon kaasi oo ku saabsan u qalmidaada loogu talagalay barnaamijyada ay maamusho Medicaid.

OAR 410-120-1210; 461-105-0020(1),(2),(6); 461-120-0330(1),(3); 461-110-0210; 461-110-0310; 461-110-0410; 461-110-0530(2),(4); 461-115-0010(1),(2),(3); 461-115-0020; 461-115-0230(5); 461-115-0540; 461-115-0610(1),(2),(3); 461-115-0700; 461-120-0315; 461-120-0345; 461-120-0510(1),(4),(5),(6),(7); 461-125-0310; 461-125-0330; 461-125-0350; 461-125-0370; 461-135-0730; 461-135-0745; 461-135-0750; 461-135-0771; 461-135-0780; 461-135-0790; 461-135-0800; 461-135-0820; 461-135-0830; 461-155-0250; 461-155-0290; 461-155-0295; 461-160-0010(3),(4),(5); 461-160-0015(3),(4),(5); 461-160-0540; 461-160-0550; 461-160-0551; 461-160-0552; 461-170-0130; 461-180-0085

16. Denial of presumptive OSIPM due to failure to comply with pursuit of SSDI and is not eligible for any APD medical - individual is receiving MAGI and applied for GA (SDS 540)

Waxaanu codsanay in aad raacdo arjigaaga loogu talagalay faa’iidooyinka Social Security-ga ee ka socda Xafiiska Social Security-ga. Ma aynaan helin caddeyn tilmaamaysa in aad taasi sameysay. Iyada oo sababtu tahay anaga oo aan helin macluumaadkan, arjigaagii gargaarka caafimaad waa la diiday. Uma qalantid barnaamijyada gargaarka caafimaad ee ay maamusho Dadka Waayeelka ah ee Naafada ah (APD). Si loogu qalmo Barnaamijka Dakhliga Caafimaad ee Dheeraadka ah ee Oregon (OSIPM), waa in ay da’daadu tahay 65 jir ama ka wayn tahay, aadan indho qabin, ama leedahay naafanimo buuxinaysa heerarka u yaala Xafiiska Social Security-ga ISLA MARKAANA leedahay u qalmid la aqbalay ama la dhowray ama aad ku siman tahay tahay xadka u yaala dakhliga iyo ilaha. Si loogu qalmo Barnaamijyada Lacag Kaydsashada ee Medicare (QMB, SMB, SMF) waa in aad leedahay Medicare Part A isla markaana leedahay dakhli ku siman xadka u yaala barnaamijka la oggol yahay. Waa in aad sidoo kale buuxisaa dhammaan shuruudaha looga baahan yahay u qalmida waxyaalaha aan dhaqaalaha ku xirnayn oo aad dhammeystirtaa arjiga codsi iyo nidaamka caddeynta si aad aad ugu qalanto barnaamijyada caafimaad ee APD. Tani ma bedelayso ama ma saameynayso wixii faa’iidooyin Medicaid ah ee aad ka helaysid Maamulka Caafimaadka Oregon.

Miscellaneous

1. Inmate of an institution - no MAGI referral needed (SDS 540)

2. Disqualifying transfer of resources (SDS 540)

Send the SDS 0540T for services and an SDS 540 for medical if the applicant is ineligible for all medical programs. Use notice language appropriate for the applicant’s scenario (e.g. over income). Otherwise approve for appropriate program. Send SDS 0544 if appropriate (see the OSIP WG-7)

3. Voluntary Withdrawal Basic decision notice - non continuing benefits (SDS 540)

Note: This notice is not needed for a denial if the client signs and submits a 457D.

Waad ka noqotay arjigaagii loogu talagalay faa’iidooyinka. Mar kasta ayaad dib u codsan kartaa. OAR 410-120-1210, 461-115-0010(6),(7), 461-175-0340(1)

SNAP Closure

1. Client is over income

Hada ka dib uma qalantid gargaarada SNAP sababta oo ah isbedel ku yimid dakhliga oo kaa dhigaya in aad ka kor marto xadka u yaala dakhliga la oggol yahay. OAR 461-155-0190, 461-160-0400, 461-150-0070, 461-160-0430, 461-160-0420, 461-160-0060, 461-180-0030; 461-135-0505

2. Client is a resident of an institution

Waxaa lagu dhigay goob date admitted to institution mm/dd/yy. Dadka degan goob lagu hayo uma qalmaan gargaarada cuntada. OAR 461-135-0510

3. Client moved into AFH

Waxaad hada degan tahay guryaha daryeelka dadka waayeelka ah. Dadka degan guryaha daryeelka dadka waayeelka ah ee ruqsada ka haysta gobolku waa in ay la codsadaan daryeel bixiyahooda si ay ugu qalmaan gargaarada cuntada. Maadaama uu daryeel bixiyahaagu aanu codsanayn gargaarada cuntada, uma qalantid faa’iidooyinkan. OAR 461-110-0370, 461-135-0530.

4. Client is a fleeing felon

Uma qalantid gargaarada cuntada sababta oo ah waxaa laguu tixgelinayaa in aad tahay mid ka mid ah ah kuwa soo socda: dambiile baxsad ku jira, qof xadgudub sameeyay ka dib xabsi laga sii daayay, qof ku xadgudubay la socod lala socday, ama qof ku xadgudubay kor kala socoshadii xabsiga dabadii. OAR 461-110-0310, 461-110-0630, 461-135-0560

5. Failure to provide requested info

Si loogu qalmo gargaarada cuntada, waxaa lagaaga baahan yahay in aad bixiso macluumaadka marka ay codsato Waaxdu. Waxaan kaa codsanay macluumaad ku saabsan specific info requested on 539H. Ma aadan keenin caddeyntaasi. OAR 461-105-0020, 461-115-0610, 461-115-0651

6. Benefits end at Recert Basic decision notice - non continuing benefits

Gargaaradaada cuntadu way joogsanayaan sababta oo ah ma aadan soo celin arjigaagii, dhammeystirin nidaamkii kulan, ama ma aadan soo sheegin isbedelka loo baahan yahay. Rules will vary based on reason. OAR 461-115-0450

7. Cannot remain in own filing group (not AFH)

Waxaa jira isbedel ku yimid qaabka gurigaagu u dhisan yahay. Waxaad hada la degan tahay insert household member(s) client now must apply with oo aad cuntada si wadajir ah u soo wada gadataan isla markaana u wada diyaarisaan. Dadka isla hal guri ku wada nool ee cuntada si wadajir ah u soo wada gata isla markaana u wada diyaariya, waa in ay si wadajir ah u codsadaan si ay ugu qalmaan gargaarada cuntada. Maadaama insert case name client will be added to uu codsaday isla markaana helo gargaarada cuntada, waxaa lagugu dari doonaa dacwadiisa gargaarka cuntada. Hada ka dib uma qalantid dacwada gargaarka cuntada oo gooni ah. Dacwadaada gargaarka cuntadu waxay joogsan doontaa laga bilaabo insert closure effective date mm/dd/yy. OAR 461-110-0370, 461-110-0210, 461-110-0310, 461-110-0530, 461-110-0750, 461-180-0010

SNAP Reduction

1. Receipt of new income CASE NOT IN SRS

Waxaad jira oo aad leedahay isbedel ku yimid dakhliga oo ay tahay in la isticmaalo marka la xisaabinayo gargaaradaada cuntada. Ku darida dakhligan lagu darayo dacwadaadu waxay keentay in gargaaradaada cuntadu hoos loo dhigo. OAR 461-155-0190, 461-160-0400, 461-150-0070, 461-160-0430, 461-160-0420, 461-160-0060, 461-180-0030

2. Change in shelter expense CASE NOT IN SRS

Waxaa jira isbedel ku yimid lacagta hoygaaga. Tani waxay keentay isbedel ku yimaada gargaarkaaga cuntada. Maadaama uu kharashka hoygaagu hoos u dhacay, gargaaradaada cuntaduna hoos ayay u dhaceen. OAR 461-160-0420, 461-160-0060, 461-155-0190, 461-160-0400, 461-160-0430, 461-180-0030

3. Change in medical deductions CASE is in SRS

Waxaa jira isbedel ku yimid kharashyadaada caafimaad. Tani waxay keentay isbedel ku yimaada gargaarkaaga cuntada. Maadaama uu kharashkaaga caafimaad hoos u dhacay, gargaaradaada cuntaduna hoos ayay u dhaceen. OAR 461-160-0055, 461-160-0060, 461-160-0400, 461-160-0415, 461-160-0430, 461-180-0030

4. Change in income CASE is in SRS

Waxaad jira oo aad leedahay isbedel ku yimid dakhliga oo ay tahay in tixgelin la siiyo marka la xisaabinayo gargaaradaada cuntada. Ku darida dakhligan lagu darayo dacwadaadu waxay keentay in gargaaradaada cuntadu hoos u dhacaan. OAR 461-170-0011, 461-180-0006, 461-155-0190, 461-160-0400, 461-150-0070, 461-160-0430, 461-160-0420, 461-160-0060, 461-180-0030

5. Change in shelter expense CASE is in SRS

Waxaa jira isbedel ku yimid lacagta hoygaaga. Tani waxay keentay isbedel ku yimaada gargaarkaaga cuntada. Marka kharashyada hoygaagu isbedelaan, waxay bedelaysaa gargaaradaada cuntada. Maadaama ay kharashyada hoygaagu hoos u dhaceen, gargaaradaada cuntaduna hoos ayay u dhaceen. OAR 461-160-0420, 461-160-0060, 461-155-0190, 461-160-0400, 461-160-0430, 461-180-0030, 461-170-0020, 461-180-0006

6.Change in household composition

Waxaa jira isbedel ku yimid qaabka gurigaagu u dhisan yahay. Tirada dadka ku nool gurigaagu waxay saameyn ku yeelatay lacagta gargaarada ah ee aad hesho. Iyada oo ay la xiriirto isbedelkan, gargaaradaadu cuntadu hoos ayay u dhaceen. OAR 461-110-0210, 461-110-0310, 461-110-0530, 461-110-0750

SNAP Denial

1. Receipt of Foods from California

Arjigaaga loogu talagalay gargaarada cuntada ee loogu talagalay insert filing date mm/yy waa la diiday sababta oo ah waxaad helaysaa faa’iidooyinka Dheeraadka ah ee Gobolka California oo uu la socdo Sugidda Dakhliga ee Kabista ah (SSI) ee aad leedahay. Faa’iidooyinka SSI ee laga bixiyay California waxaa ku jira lacag aad adigu leedahay si aad ugu isticmaasho in aad ku gadato cunto. Sababta oo ah waxaad helaysaa faa’iidooyinka Dheeraadka ah ee Gobolka California ee insert filing date mm/yy sida laga soo caddeeyay Social Security-ga, isla waqtigan isku midka ah ma oggolaan karno gargaaradaada cuntada ee Oregon. Gargaarada isla waqti isku midka ah kama heli kartid laba gobol oo kala duwan. OAR 461-165-0030, 461-110-0370

2. Client does not meet citizenship/alien status requirements

Si aad u hesho gargaarada cuntada, waa in aad tahay muwaadin Maraykan ah ama waa in aad buuxiso shuruudaha loo baahan yahay qofka u qalma ee aan muwaadinka ahayn. Waxaad soo gashay Maraykanka insert date of entry to US mm/yy. Laguuma tixgelinayo in aad tahay qoxooti ama halkan uma joogtid magan gelyo. Ma buuxinaysid shuruudaha kale ee gaarka ee INS ee loogu talagalay deganaanshaha Maraykanka. Ma aadan shaqeynin 40 qaybood ee loogu qalmayo ‘qualifying quarters’ adiga oo degan Maraykanka. Ma haysid shaqo ciidan ama ma tihid qof soo halgamay oo ka tirsan ciidamada qalabka ee Maraykanka. Si sharci ah uma aadan deganayn Maraykanka muddo 5 sano ah. Uma qalantid barnaamijyada gargaarada cuntada. OAR 461-120-0110, 461-120-0125

3. Failure to provide requested info

Si loogu qalmo gargaarada cuntada, waxaa lagaaga baahan yahay in aad bixiso macluumaadka marka ay codsato Waaxdu. Waxaan kaa codsanay macluumaad ku saabsan specific info requested on 539H. Ma aadan bixin caddeyntaasi. OAR 461-105-0020, 461-115-0610, 461-115-0651

4. Client is a fleeing felon

5. Medical deduction denial
(choose one)

Does not meet definition of eldery or disabled: Codsigaagii ahaa in kharashka caafimaadka ku baxay laga jaro gargaarada cuntada waa la diiday adiga oo aan buuxinayn qeexitaanka gargaarka cuntada ee qof waayeel ah ama qof naafo ah. OAR 461-001-0015
Expense is in the last month of certification and already paid: Codsigaagii ahaa in kharashka caafimaadka ku baxay laga jaro gargaarada cuntada waa la diiday iyada oo kharashka la soo sheegay uu ku jiro bisha ugu dambeysa ee wakhtiga laguu aqoonsaday qaadashadiisa. Maadaama isla hadaba la bixiyay biilka ma jiro isku dheelitir lagu samaynayo gargaaradaada cuntada. OAR 461-001-0000, 461-115-0450, 461-160-0415, 461-180-0020
Expense paid in prior certification period: Codsigaagii ahaa in kharashka caafimaadka ku baxay laga jaro gargaarada cuntada waa la diiday iyada oo kharashka caafimaadka ee la soo sheegay si buuxda loo bixiyay ka hor wakhtiga laguu aqoonsaday qaadashadiisa isla markaana laba jeer ma sheegan kartid biil isku mid ah. OAR 461-001-0000, 461-160-0030, 461-160-0415
Past due expense and no installment plan: Codsigaagii ahaa in kharashka caafimaadka ku baxay laga jaro gargaarada cuntada waa la diiday iyada oo kharashka caafimaadka ee la soo sheegay wakhtigiisii la dhaafay isla markaana aadan lahayn qorshe aad lacagta ku bixinayso ama qorshaha lacagta bixinta oo aanan la samayn. OAR 461-160-0415
Paid by someone outside filing group: Codsigaagii ahaa in kharashka caafimaadka ku baxay laga jaro gargaarada cuntada waa la diiday iyada oo kharashka caafimaadka ee la soo sheegay in uu bixiyay qof ka baxsan kooxda dalbanaysa gargaarada cuntada isla markaana aadan adigu u sheegan karin kharash ahaan. OAR 461-160-0030
Not prescribed or provided by medical practitioner: Codsigaagii ahaa in kharashka caafimaadka ku baxay laga jaro gargaarada cuntada waa la diiday iyada oo kharashka caafimaadka ee la soo sheegay aanu dhakhtar qorin ama aanu bixin dhakhtar caafimaad. OAR 461-160-0055
Expense is for person no longer in HH: Codsigaagii ahaa in kharashka caafimaadka ku baxay laga jaro gargaarada cuntada waa la diiday iyada oo kharashka caafimaadka ee la soo sheegay loogu talagalay qof aan hada ka dib ka tirsanayn kooxda gurigaaga joogta. OAR 461-110-0210, 461-110-0370, 461-160-0415, 461-160-0030
Failure to provide verification: Codsigaagii ahaa in kharashka caafimaadka ku baxay laga jaro gargaarada cuntada waa la diiday. Waxaa lagaaga baahan yahay in aad bixiso macluumaadka marka ay codsato Waaxdu. Waxaan kaa codsanay macluumaad ku saabsan specific information requested on 539H. Ma aadan bixin caddeyntaasi. OAR 461-001-0015, 461-105-0020, 461-115-0610, 461-115-0651, 461-160-0055

Service Issues - Translation not yet available. To request translation of the English sample language complete DHS 1001 and send to DHS-OHA.PublicationRequest@state.or.us and CC Rebecca Arce at rebecca.e.arce@dhsoha.state.or.us.

Special Needs Closure
1. No longer eligible for payment for food for guide dogs and special assistance animals	Hada ka dib uma qalantid in aad hesho lacagta la bixiyo ee dhan $insert amount received for dog food ee loogu talagalay eyda dadka hagta ‘guide dogs’ama xayawaanka wax caawiya sababta oo ah: Choose one: Hada ka dib ma jirto eyga dadka hagta ‘guide dog’ama xayawaanka wax caawiya oo aad leedahay (You no longer have a guide dog or special assistance animal) Hada ka dib ma helaysid SSI ama dakhligaaga la isku dheelitiray ayaanan ka hooseynin heerka dakhli ee OSIPM (You no longer receive SSI or your adjusted income is not below the OSIPM income standard) Hada ka dib ma helaysid daryeelka guriga iyo bulshada ku saleysan (You no longer receiving home or community-based care) Hada ka dib ma helaysid faa’iidooyinka OSIPM (You no longer receiving OSIPM benefits) OAR 410-120-1210,461-155-0500, 461-155-0530.
2. No longer eligible for laundry allowance	Hada ka dib uma qalantid in aad hesho lacagta bishii loo qoondeeyay dhar dhaqida ee dhan $insert amount currently receiving sababta oo ah: Choose one: Hada ka dib ma helaysid SSI ama dakhligaaga la isku dheelitiray ayaanan ka hooseynin heerka dakhli ee OSIPM (You no longer receive SSI or your adjusted income is not below the OSIPM income standard) Hada ka dib ma helaysid OSIPM (You no longer receive OSIPM) Hada ka dib ma jirto kharashyada meel la soo caddeeyay oo lacagta qadaadiicda/sarifka ah ku sheqaysa ‘coin-operated’ oo dharka lagu dhaqo oo aad leedahay (You no longer have proven excessive coin-operated laundry facility costs) Waxaad guurtay meel adeega dhar dhaqida si lacag la’aan ah laguu siiyo ama waxaad leeday meel wax lagu dhaqo oo kuu gaar ah (You have moved to a location where laundry service is provided to you for no charge or you have your own laundry facilities) OAR 410-120-1210, 461-155-0500, 461-155-0580.
3. No longer eligible for ongoing CBC room and board payment	Hada ka dib uma qalantid lacagta daryeelka baahiyaha gaarka ah ee bulshada ku saleysan si aad u bixiso lacagta qolkaaga ama kharashyada guddiga ee xarunta bulshada ku saleysan. Lacagtu ayaa ah farqiga u dhexeeya heerka dakhli ee OSIPM ee loogu talagalay hal qof iyo wadarta dakhligaaga la xisaabin karo. OAR 410-120-1210, 461-155-0500, 461-155-0630
4. No longer eligible for supplemental telephone allowance	Hada ka dib uma qalantid lacagta dheeraadka ee wada xiriirka ee la qoondeeyay sababta oo ah adiga oo aan: Choose one: Hada ka dib helayn SSI ama dakhligaaga la isku dheelitiray ayaanan ka hooseynin heerka dakhli ee OSIPM (You are no longer receiving SSI or your adjusted income is not below the OSIPM income standard) Hada ka dib helayn adeegyada guriga-dhexdiisa laga bixiyo (You are no longer receiving in-home services) Hada ka dib awoodid in aad ka baxdo goobta aad degan tahay iyada oo gacan lagu siiyo maahane (You are no longer unable to leave your residence without assistance) Hada ka dib helayn faa’iidooyinka OSIPM (You are no longer receiving OSIPM benefits) OAR 410-120-1210, 461-155-0500, 461-155-0680 Note: If the Department is paying the ongoing monthly cost for an Emergency Response System (e.g. Oregon Lifeline) add the following before the list of OARs: Lacagtan la qoondeeyay waxaa lagu daboolay kharashka bil kasta ee Nidaamkaaga Jawaabta Degdega ah ‘Emergency Response System’. Waxaanu ogeysiinay insert vendor name* in laga bilaabo insert date ERS ends mm/dd/yy, in Waaxdu aanay hada ka dib bixin doonin lacagta nidaamkan. Fadlan qorshe la sameyso vendor name si aad u bilowdo in aad si gaar ah u bixiso ama aad soo celiso qalabkaaga.
6. No longer eligible for payment for prescription drug co-pays	Hada ka dib uma qalantid in aad hesho lacagta bishii la bixiyo ee dhan $insert amount currently receiving ee loogu talagalay co-pay-ga daawooyinkaaga la isku qoro sababta oo ah hada ka dib ma helaysid SSI ama co-pay-ga daawooyinkaaga la isku qoro ayayna wadartiisu dhanayn $10 ama wax ka badan bil kasta. OAR 410-120-1210, 461-155-0500, 461-155-0688
7. No longer eligible for in-home supplement	Hada ka dib uma qalantid in aad hesho lacagta Dheeraadka ah ee Daryeelka Guriga-dhexdiisa laga bixiyo ee dhan $22 bishii sababta oo ah hada ka dib ma helaysid: Choose One: SSI isaga oo ah ilaha kaliya ee dakhli ee aad hesho (SSI as your only source of income) Adeegyada guriga-dhexdiisa laga bixiyo (In-home services) Qorshaha Gobolka ee Adeegyada Daryeelka Shakhsi (State Plan Personal Care services) Xafiiska Adeegyada Naafanimada Koriinka ee daryeelka guriga-dhexdiisa laga bixiyo ama bulshada ku saleysan (Office of Developmental Disabilities Services in-home or community-based care) OAR 410-120-1210, 461-155-0500, 461-155-0575
8. No longer eligible for PIF and room and board allowance	Hada ka dib uma qalantid kharashka qofka ku yimaada iyo qolka iyo lacagta loo qoondeeyay guddiga sababta oo ah: Choose One: Dakhligaaga la xisaabin karo wuu ka badan tahay heerka dakhli ee OSIPM (Your countable income is more than the OSIPM income standard) Dakhligaaga la xisaabin karo wuu kordhay iyada oo qofka aad isqabtaan uu/ay hada buuxinayo/buuxinayso kharashkiisa/keedii bishii iyada oo aanay ku jirin lacag la qoondeeyay (Your countable income has increased and your spouse can now meet their monthly expenses without the allowance) Dakhliga qofka aad isqabtaan wuu kordhay iyada oo uu/ay hada buuxinayo/buuxinayso kharashkiisa/keedii bishii iyada oo aanay ku jirin lacag la qoondeeyay (Your spouse’s income has increased and now they can meet their monthly expenses without the allowance) Hada ka dib ma deganid xarun daryeel oo bulshada ku saleysan (You no longer reside in a community-based care facility) Hada ka dib uma qalantid adeegyada guriga iyo bulshada ku saleysan (You are no longer eligible for home and community-based services) OAR 410-120-1210,461-155-0500, 461-155-0700, 461-160-0620

Special Needs Reduction

1. Reduction of prescription co-pay payments

Lacagtaada la bixiyo bishii ee dhan $amount of current payment ee loogu talagalay co-pay-ga daawooyinkaaga la isku qoro waxaa hoos loogu dhigi doonaa $amount of new payment laga bilaabo effective date of change mm/dd/yy iyada oo ay ku saleysan tahay kharashyada bishii ee hoos loo dhigay ee aad keentay date proof of costs provided mm/dd/yy.

OAR 410-120-1210, 461-155-0500, 461-155-0688

2. Reduction of PIF and room and board allowance

Lacagtaada la bixiyo bishii ee dhan $amount of current payment ee loo qoondeeyay kharashka qofka ku yimaada iyo qolka iyo guddiga waxaa hoos loogu dhigi doonaa $amount of new payment laga bilaabo effective date of change mm/dd/yy sababta oo ah waxaa jira in aad yeelatay koror ku yimid dakhligaaga la xisaabin karo. OAR 410-120-1210,461-155-0500, 461-155-0700, 461-160-0620

Special Needs denial
1. Denial of payment for guide dog or assistance animal food	Uma qalantid in aad hesho lacagta la bixiyo ee loogu talagalay eyga dadka hagta ‘guide dog’ama xayawaanka wax caawiya sababta oo ah xayawaankaagu waa xayawaan wehel ah isla markaana si gaar ah looguma tababarin in uu qabto hawlo si uu u buuxiyo baahiyahaaga caafimaad ee gaarka ah ama hawlaha dhanka jirka oo gaar ah ee aadan awoodin in aad qabato si aad u sii wadato madax bannaanida aad leedahay. OAR 410-120-1210, 461-155-0500, 461-155-0530(1)(3)
2. Denial of laundry allowance	Uma qalantid in aad hesho lacagta bishii loo qoondeeyay dhar dhaqida ee dhan sababta oo ah: Choose One: Ma helaysid SSI iyada oo dakhligaaga la isku dheelitiray aanu ka hooseynin heerka dakhli ee OSIPM (You do not receive SSI and your adjusted income is not below the OSIPM income standard) Ma helaysid OSIPM (You do not receive OSIPM) Ma lihid kharashyada meel la soo caddeeyay oo lacagta qadaadiicda/sarifka ah ku sheqaysa ‘coin-operated’ oo dharka lagu dhaqo (You do not have proven excessive coin-operated laundry facility costs) Waxaad guurtay meel adeega dhar dhaqida si lacag la’aan ah laguu siiyo ama waxaad leedahay meel wax lagu dhaqo oo kuu gaar ah (You have moved to a location where laundry service is provided to you for no charge or you have your own laundry facilities) OAR 410-120-1210,461-155-0500, 461-155-0580
3. Denial of payment for home repairs	Uma qalantid lacagta la bixiyo ee loogu talagalay dayactirka guriga sababta oo ah: Choose One: Ma tihid qofka guriga leh ama qof la degan qof ay wada leeyihiin (You are not the homeowner or joint owner of the dwelling) Dayactirku ma aha mid lagama maarmaan ah si meesha looga saaro wax halis jireed ku ah caafimaadkaada iyo badbaadadaada (The repair is not necessary to remove a physical hazard to your health and safety) Kharashka dayactirka ayaa ka badan yahay kharashka u guuritaanka guri kale (The repair cost is more than the cost of moving to another home) Qiimaha isticmaalka ma aha mid u dhigma qorshahaaga adeeg (The use value is not consistent with your service plan) Maad keenin saddex dalab oo wanaagsan oo lagu tartamayo oo loogu talagalay dacaytirka iyada oo ay jiraan saddex ama in ka badan oo adeeg bixiyayaal ah oo laga heli karo degaankaaga (You have not provided three competitive bids for the repairs and there are three or more providers available in your area) Adeeg bixiyuhu shaqada uma qaban sida ay dhigayaan xeerarka u yaala dhismaha ee hada jira (The provider did not complete the work within current building codes) Shaqada ma aanu qaban qandaraasle dhismeed oo ruqsad iyo dammaanad haysta (The work was not completed by a licensed and bonded construction contractor) OAR 410-120-1210,461-155-0500, 461-155-0600 *If denied because already exceeded the maximum benefit within the last 24 months:* Lacag bixinta loogu talagalay dayactirka gurigu waxay ku kooban yahay $1,000 taasi oo ah 24 bilood ee kasta; intaasi waxaa sii dheer, haddii guriga si wadajir ah oo loo wada leeyahay, oo aadan adeegyada ku qornayn, isla markaana qofka kale ee guriga kula leh aanu ahayn qof aad isqabtaan, lacag bixinta ayaa lagu qiimeeyaa hab ku saleysan boqolkiiba ee lahaanshaha guriga. Uma qalantid lacagta la bixiyo ee loogu talagalay dayactirka guriga sababta oo ah isla hadaba waad ka kor martay heerka faa'iidada ugu badan ee loogu talagalay 24-kii bilood ee la soo dhaafay. Mar kale uma qalmi doontid faa’iidadan ilaa laga gaarayo date eligible again (end of 24mos) mm/dd/yy. OAR 410-120-1210, 461-155-0500, 461-155-0600
4. Denial of payment for moving costs	Uma qalantid lacagta la bixiyo ee loogu talagalay kharashyada guurida sababta oo ah: Choose One: Guuritaankaagu ma ahayn natiijo ka dhalatay guri halis ah oo aad ku nooshahay, rabshad qoys oo jirta, ama iyada oo lagaa saaray guriga (Your move was not a result of hazardous housing, domestic violence, or eviction) Guuritaankaagu wuxuu ahaa sababo aan ka ahayn ijaarka oo aan la bixin (Your move was for reasons other than non-payment of rent) Baahiyahaaga oo aan si fiican loo buuxin doonin marka aad ka baxdo gobolka (Your needs would not be better met out of state) Heerkaaga adeegyo oo aan kordhin ama hoos u dhicin iyaga oo gaaray ilaa xad ay lagama maarmaan noqoto in aad ka guurto xaaladaada nololeed ee aad hada ku jirto (Your level of services has not increased or decreased to the extent that it is necessary for you to move from your current living situation) OAR 410-120-1210, 461-155-0010, 461-155-0500, 461-155-0610. *If denied because already exceeded the maximum benefit within the last 12 months: Uma qalantid lacagta la bixiyo ee loogu talagalay kharashyada guurida. Lacag bixinta loogu talagalay kharashyada guurida waxay ku kooban yahay $1,000 isla markana kama badna hal guuritaan 24 bilood ee kasta. Waxaad heshay $amount previously received* oo luugu talagalay soo guurida date received mm/yy, taasi oo ahayd wakhti ka mid ah 12 bilood ee la soo dhaafay. OAR 410-120-1210, 461-155-0500, 461-155-0610
5. Denial of supplemental communication allowance	Hada ka dib uma qalantid lacagta dheeraadka ee wada xiriirka ee la qoondeeyay sababta oo ah: Choose One: Ma helaysid SSI iyada oo dakhligaaga la isku dheelitiray aanu ka hooseynin heerka dakhli ee OSIPM (You do not receive SSI and your adjusted income is not below the OSIPM income standard) Ma helaysid adeegyada guriga-dhexdiisa laga bixiyo (You do not receive in-home services) Waxaad awoodaa in aad ka baxdo goobta aad degan tahay iyada oo aan gacan lagu siinayn (You are able to leave your residence without assistance) Ma helaysid faa’iidooyinka OSIPM (You do not receive OSIPM benefits) OAR 410-120-1210,461-155-0500, 461-155-0680
6. Denial of payment for prescription co-pays	Uma qalantid in aad hesho lacagta bishii la bixiyo ee dhan ee loogu talagalay co-pay-ga daawooyinkaaga la isku qoro sababta oo ah hada ka dib ma helaysid SSI ama co-pay-ga daawooyinkaaga la isku qoro ayayna wadartiisu dhanayn $10 ama wax ka badan bil kasta. OAR 410-120-1210,461-155-0500, 461-155-0688

If you have a disability and need a document on this Web site to be provided to you in another format, please contact the Office of Document Management (ODM) at 503-378-3486 or by e-mail at dhs.forms@state.or.us.

If you have questions about DHS or problems getting DHS services, send e-mail to dhs.info@state.or.us. If you have comments about this site, send e-mail to spd.web@state.or.us.

APD Worker Guide

G.9 Decision Notice Preparation Tips (Somali)

Updated 1/1/20

MEDICAL: Closure Reduction Denial Miscellaneous

SNAP: Closure Reduction Denial

SERVICE: Translations not currently available

SPECIAL NEEDS: Closure Reduction Denial

TRANSLATIONS: English Spanish Russian Simplified Chinese Traditional Chinese Vietnamese

Eligibility Issues

Medical Closure

Situation

Medicare Recipient

Non-Medicare Client

Medical Reduction

Medical Denial

Miscellaneous

SNAP Closure

SNAP Reduction

SNAP Denial

Service Issues - Translation not yet available. To request translation of the English sample language complete DHS 1001 and send to DHS-OHA.PublicationRequest@state.or.us and CC Rebecca Arce at rebecca.e.arce@dhsoha.state.or.us.

Special Needs Closure

Special Needs Reduction

Special Needs denial

If you have a disability and need a document on this Web site to be provided to you in another format, please contact the Office of Document Management (ODM) at 503-378-3486 or by e-mail at dhs.forms@state.or.us.

If you have questions about DHS or problems getting DHS services, send e-mail to dhs.info@state.or.us. If you have comments about this site, send e-mail to spd.web@state.or.us.

Oregon Department of Human Services 500 Summer St. NE E02, Salem, OR 97301-1073 Phone: (503) 945-5811 Toll-free: (800) 282-8096 (V/TTY)

Oregon Department of Human Services
500 Summer St. NE E02, Salem, OR 97301-1073
Phone: (503) 945-5811
Toll-free: (800) 282-8096 (V/TTY)