All Medicaid Programs |
Obsolete Policy |
The following may be eligible for UPP:
Individuals who have access to or who are covered by COBRA.
Individuals who have access to employer sponsored insurance but have not yet enrolled (See 1003-1).
Individuals are enrolled if they have signed up for the plan and they are receiving benefits under that plan.
If the individual is able to complete the enrollment process within 90 days of the application date or is in the waiting period, they may be found eligible for UPP. However, they cannot begin to receive an UPP reimbursement until the month they pay a health insurance premium.
An individual enrolled in a FFM plan may be found eligible for UPP, if they now have access to employer sponsored insurance. Coordinate enrollment in UPP with the termination of the FFM plan. Individuals enrolled in an individual health insurance plan that is not through the FFM are not eligible unless they meet an exception (See 1003-11).
The following individuals would not be eligible for UPP.
Individuals who are enrolled and currently receiving benefits in an employer-sponsored health plan through their employer, their spouse’s employer, or their parent's or legal guardian's employer
Individuals who are enrolled in Medicare Part A or Part B.
Individuals who are enrolled in health insurance coverage through the Veteran's Administration Health Care System.
Individuals who are enrolled or have access to enroll in a student health insurance plan.
Individuals who are enrolled in any other type of group health insurance plan that is not considered limited coverage (See 1003-1).
Exceptions:
UPP recipients moving to Medicaid and then back to UPP (See 1009-5).
Individuals completing their review within 3 months of a review closure (See 1008-2).