All Medicaid Programs |
Obsolete Policy |
Process application
Each application must be processed to a decision for each applicant unless:
The client and other household members are already on the most beneficial medical program. If no better coverage is available, document that no action was taken on the application.
The client has already applied and that application is still pending
The client withdraws the application
The client cannot be located, in which case deny the application. If the client contacts the agency before the end of the application-processing period, resume the application process.
Effective January 1, 2010, process data transmitted from SSA Low Income Subsidy (LIS) applications as an application for Medicare Cost-Sharing programs.
LIS data is not an application for Medicaid.
LIS data transmitted from SSA meets the signature requirements for Medicare Cost-Sharing programs.
See Sec. 703-1 on applications
Process an application received from the FFM within 30 days of receiving the electronic account.
Deny applications that do not meet the signature requirements within the application-processing time as an incomplete application. Do not make a determination of eligibility.
See Sec. 703-1 on applications and signature.
See Sec. 703-3 on who can apply and how to get the best signature.
Provide Information
All applicants have the right to register to vote at application.
See Sec. 109 Voter Registration Requirements
Workers need to tell clients who are age 19-64 about the Disability Medicaid program. Workers must give or mail a copy of the brochure called Medicaid for People with Disabilities to all clients who are 19-64 years old.
See section 303-3 if the client claims to be disabled or blind.
The Dept of Health will mail the Child Health Evaluation and Care (CHEC) information to households with pregnant women and children when medical benefits are approved.
Determine Eligibility
Consider Eligibility for the Retroactive Period.
See Sec. 705 on retroactive assistance.
Always determine retroactive eligibility for SLMB and QI programs for all applicants who are Medicare eligible, including LIS applicants received from SSA.
Request any needed verifications.
An interview may be helpful in gathering information, but is not required.
Screen the application and request the needed verifications. Send a written request for verifications to the applicant. See Sec. 731 for more information about the verification process.
LIS application data from SSA will be incomplete. Request additional information and required verifications needed to process the application.
Give applicants at least 10 days from the mailing date of the request to return verifications. Applicants may request more time by the due date, in which case, give applicants at least 10 more days.
Applicants have until the end of the application-processing period to provide verifications. Do not deny an application for lack of verifications until the end of the processing period. The processing period is 30 or 90 days, as applicable.
Request only those verifications that the agency cannot obtain through other means like electronic matches.
Determine eligibility after receiving verifications. See Sec. 703-5.
Mail a notice of the eligibility decision to the applicant, and the representative if applicable. See Sec. 811.
The electronic client information will be transferred to the FFM when an application is denied.
Document decisions made on each application in the case record. See Sec. 703-5.