Skip Nav
AMBER Alert has been DEACTIVATED for Leilani Williams Leilani William has been recovered.

Medical Assistance Manual

MANUAL TRANSMITTAL LETTERS

MEDICAL ASSISTANCE MANUAL - CONTENTS

MEDICAL ASSISTANCE MANUAL - APPENDIX

Medical Assistance Manual Transmittal Letters

UPDATED MTL TITLE
08/19/2025 12-25 August 2025 Release
08/14/2025 11-25 August 2025 Release
08/13/2025 10-25 August 2025 Release
08/08/2025 09-25 August 2025 Release
08/08/2025 08-25 August 2025 Release
07/16/2025 07-25 July 2025 Release
07/16/2025 06-25 July 2025 Release
04/17/2025 05-25 April 2025 Release
04/03/2025 04-25 April 2025 Release
03/17/2025 03-25 March 2025 Release
03/06/2025 02-25 March 2025 Release
01/15/2025 01-25 January 2025 Release
11/27/2024 11-24 November 2024 Release
11/19/2024 10-24 November 2024 Release
11/13/2024 09-24 November 2024 Release
09/25/2024 08-24 September 2024 Release
09/18/2024 07-24 September 2024 Release
09/16/2024 06-24 September 2024 Release
09/12/2024 05-24 September 2024 Release
09/06/2024 04-24 September 2024 Release
04/02/2024 03-24 April 2024 Release
01/26/2024 02-24 January 2024 Release
01/22/2024 01-24 January 2024 Release
11/13/2023 06-23 November 2023 Release
09/29/2023 04-23 October 2023 Release
07/05/2023 03-23 July 2023 Release
04/05/2023 02-23 April 2023 Release
01/05/2023 01-23 January 2023 Release
07/01/2022 03-22 July 2022 Release
04/01/2022 02-22 April 2022 Release
01/05/2022 01-22 January 2022 Release
10/01/2021 04-21 October 2021 Release
07/01/2021 03-21 July 2021 Release
04/01/2021 02-21 April 2021 Release
01/05/2021 01-21 January 2021 Release
10/01/2020 04-20 October 2020 Release
07/01/2020 03-20 July 2020 Release
04/01/2020 02-20 April 2020 Release
02/25/2020 01-20 January 2020 Release
02/06/2020 03-19 July 2019 Release
01/31/2020 02-19 April 2019 Release
03/03/2020 01-19 January 2019 Release
02/06/2020 05-18 October 2018 Release
11/22/2019 04-18 July 2018 Release
11/22/2019 03-18 May 2018 Release
11/22/2019 02-18 March 2018 Release
11/22/2019 01-18 January 2018 Release
11/22/2019 06-17 November 2017 Release
11/22/2019 05-17 September 2017 Release
02/06/2020 04-17 July 2017 Release
11/22/2019 03-17 May 2017 Release
11/22/2019 02-17 March 2017 Release
11/22/2019 01-17 January 2017 Release
11/22/2019 05-16 November 2016 Release
11/22/2019 04-16 September 2016 Release
11/22/2019 03-16 July 2016 Release
02/06/2020 02-16 May 2016 Release
03/03/2020 01-16 January 2016 Release
02/25/2020 01-15 Medical Assistance Manual
01/31/2020 13-01 Medical Manual Released

Medical Assistance Manual Table of Contents

UPDATED MTL TITLE
08/13/2025 10-25 Table of Contents
09/18/2024 07-24 A-100 - Medical Assistance Overview
11/19/2024 10-24 A-200 - Definitions and Acronyms
04/17/2025 05-25 B-100 - Modified Adjusted Gross Income (MAGI) Medical Categories
11/22/2019 04-17 B-200 - Specialized Medical Categories
03/06/2025 02-25 B-300 - Medical Assistance for the Aged, Blind, and Disabled (MAABD) Medical Categories
01/26/2024 02-24 C-100 thru C-800 - General Eligibility Requirements
07/16/2025 07-25 D-100 - MAGI Application Processing
11/22/2019 04-17 D-200 - Specialized Group Application Processing
08/14/2025 11-25 D-300 - MAABD Application Processing
11/22/2019 02-16 D-400 - Redeterminations
04/03/2025 04-25 D-500 - Changes
09/29/2023 04-23 E-100 - MAGI Budget Methodology
11/13/2024 09-24 E-200 - MAABD Budget Methodology
09/29/2023 04-23 E-300 - Types of Earned and Unearned Income
09/09/2024 04-24 E-400 - Resources
08/08/2025 08-25 F-100 - Long Term Care Services
01/25/2024 02-24 F-200 - Home and Community Based Waivers
09/12/2024 05-24 F-300 - Persons Institutionalized Less Than 30 Consecutive Days
09/29/2023 04-23 F-400 - Transfer of Assets
03/17/2025 03-25 F-500 - Treatment of Trusts
01/06/2020 01-20 G-100 thru G-300 - Non-Discrimination of Hearings and Claims
09/29/2023 04-23 H-100 - Presumptive Eligibility Provider Guidance
09/29/2023 04-23 H-200 - Presumptive Eligibility DWSS Case Manager Guidance

Medical Assistance Manual Appendices

UPDATED MTL TITLE
07/16/2025 06-25 Appendix A - MAGI Income Charts Verification Plan AID Code Charts
08/19/2025 12-25 Appendix B - Possible Benefits Available to Division of Welfare and Supportive Services Clients
09/25/2024 08-24 Appendix C - MAABD Income Standard Chart
09/16/2024 06-24 Appendix D - Benefit Level Chart
01/31/2020 13-01 Appendix E - BIC Code Values
08/08/2025 09-25 Appendix F - MAABD Budgets
12/02/2019 13-01 Appendix G - PRUCOL Verification
02/04/2020 04-17 Appendix H - Determining Countable RSDI Payments for MAGI Budgeting
01/05/2023 01-23 Appendix I - Non-Citizen Documentation Matrix