Medicaid Policy
Medicaid Policy
There are two steps in determining eligibility for UPP at application that must occur prior to issuing an UPP premium reimbursement.
Application Timeframes:
The agency must determine if the applicant meets the basic criteria for UPP within 30 days of the date of application unless additional time is needed. (See Section 703-5)
The agency must notify the applicant of the decision and the requirements to enroll in an UPP qualified employer sponsored insurance or COBRA health plan.
Premium Verification Timeframes
Once the agency determines eligibility requirements for UPP have been met, the applicant must enroll in the employer-sponsored health plan or COBRA within 30 days of receiving the eligibility determination notice.
The agency must give the individual at least 45 days to provide proof of payment of the premium and proof of enrollment in order to receive the UPP reimbursement.
If the applicant fails to provide all requested verification by the due date, the application will be denied.
Applicants may request more time to provide verifications if needed. (See Section 731)
Applicants must make the request by the due date.
If the applicant does not enroll in the employer-sponsored health insurance plan or COBRA within 30 days of the date that the eligibility agency sends the eligibility determination notice, the eligibility agency shall deny the application.