Medicaid Policy                                                                 

700 Eligibility Determination and Eligibility Review

Effective Date: September 1, 2004

No Previous Policy

 

This section describes the application and eligibility determination process.  It also discusses the review process and verification process.

Eligibility is determined whenever an individual applies for assistance, and when an open case is reviewed.  Eligibility is also determined when changes are reported, and when the agency learns about changes in the individual's situation.

The eligibility worker determines an individual's eligibility for assistance by

1. Applying the Medicaid policy for program, income and asset standards to the individual's or household's circumstances, and,

2. Establishing the validity and accuracy of the information given by the applicant, or received from other sources.