Obsolete 0523 - 357 DHHS COVID-19 Uninsured Testing Coverage

Effective Date: June 1, 2020 - May 11, 2023

No Previous Policy

Designated DHHS staff determine eligibility for COVID-19 Uninsured Testing Coverage. To determine eligibility, staff must follow the eligibility guidelines below:

A. Eligibility Requirements

1. Eligibility is based on an individual’s statement.

2. Individuals must meet residency and citizenship/non-citizen status requirements.

3. There are no income, asset or age limits.

4. Individuals must be uninsured.

· Individuals receiving Medicaid, CHIP, Medicare, TRICARE, Veterans Administration, a federal employee health plan, group health plan or health insurance coverage offered by a health insurance issuer including a qualified health plan through an Exchange, employer-sponsored health insurance, retiree health plans or COBRA coverage do not qualify.

· Individuals enrolled in a limited-benefit Medicaid eligibility group are not considered insured. Limited-benefit insurance includes plans that only cover certain diseases, such as cancer. Limited benefit Medicaid groups include individuals infected with tuberculosis.

B. Application Process

1. Individuals can apply online through the Presumptive Eligibility Portal (PEP). The application also serves as an ongoing medical application unless the individual opts out.

· There is no limit to the number of times an individual can apply.

2. Coverage begins on the first day of the month in which the application is approved.

· Retroactive coverage is allowed but no earlier than March 18, 2020.

3. Eligible individuals receive coverage through the end of the month in which the emergency period ends.

· DHHS will determine eligibility for individuals previously determined eligible by HPE providers but lose COVID-19 Uninsured Testing Coverage at the end of the PE period.

4. The COVID-19 Uninsured Testing Coverage application and form 40 are sent to DWS through PEP.

· DWS enters the eligibility decision into eRep.

· DWS registers the ongoing medical application unless the individual opts out.

· DWS sends the COVID-19 approval or denial notice to the individual(s).

· DWS refers COVID-19 PE approvals needing coverage prior to the eligibility start date to DHHS.