Common use of Functional Eligibility Clause in Contracts

Functional Eligibility. Functional eligibility for Family Care, Partnership and PACE is determined using the Long-Term Care Functional Screen (See Section G., Long-Term Care Functional Screen of this Article). a. In order to be functionally eligible for Partnership or PACE, an otherwise eligible individual must have a nursing home level of care as determined by the Long-Term Care Functional Screen. The benefit package available to a Partnership or PACE member is identified in Addendum XII.A. and C. b. In order to be functionally eligible for Family Care, an otherwise eligible individual must have either a nursing home level of care or a non-nursing home level of care as determined by the Long-Term Care Functional Screen. i. The benefit package available to a Family Care member who has a nursing home level of care is identified in Addendum XII.A. and B. ii. The benefit package available to a Family Care member who has a non-nursing home level of care is identified in Addendum XII.B.