|
All Medicaid Programs |
|
Obsolete Policy |
Effective Date: December 1, 2019 - February 29, 2020
No Previous Policy
Do not close or deny individuals who are incarcerated (such as, a jail, prison or juvenile correctional facility). While incarcerated an individual will still be Medicaid eligible, but their Medicaid benefits will be suspended.
The following outlines the requirements for suspending Medicaid benefits.
1. Suspension of benefits will begin the day following incarceration.
o The suspended individual’s review month will not change.
2. Reviews will follow the review process outlined in 721-1 (Conduct an ex parte review whenever possible). Reviews are required every 12 months for suspended individuals with the exception of:
o Individuals under age 21 (Including individuals under age 21 on Adult Expansion); and
o Individuals suspended on the Former Foster Care (FFC) program.
3. Prior to reinstating Medicaid benefits for suspended individuals under age 21 or on FFC, a redetermination of eligibility is required.
4. Medicaid coverage will be reinstated the day of release and the following will apply:
Review month will not change (Individuals under age 21 and FFC individuals will have a new review month once the determination is completed).
Workers will need to determine if the individual is still eligible for the suspended program (such as, still eligible for PCR or PW). If not eligible, determine eligibility for another Medicaid program, such as Adult Expansion.
5. For an inpatient stay or a disability determination following a suspension see 303-10.