Frequently Asked Questions

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Using Medicaid Analytic eXtract (MAX), how can a data user determine which Medicaid enrollees have restricted benefits? 

The primary way to identify enrollees who have restricted benefits is by using the monthly restricted benefits flag (data element #55 in MAX 2005-2009).  In addition, some dual Medicaid and Medicare enrollees have restricted benefits.  Using monthly Medicaid dual code (data element #38 in MAX 2006-2009), users can identify specific types of dual enrollees with restricted benefits:  QMB only (codes = 01 and 51), SLMB only (codes = 03 and 53), QDWI (codes = 05 and 55), QI-1 (codes = 06 and 56), QI-2 (codes = 07 and 57).

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